New Patient Portal Information – Please Read (Effective 12/1/24)

Dear Parents,

Since our opening in 2021, we have offered our patient portal services completely free of charge. While we believe this service is an important method of communication, we have noticed a sharp increase in portal messages over time. We have done our best to respond to messages promptly, providing availability for 16 hours a day. However, managing these messages has become more than a full-time responsibility, requiring our providers and staff to volunteer significant time after hours and on weekends, often taking time away from their families.

Previously, insurance companies did not consider portal messaging a form of “telemedicine.” However, they now allow us to bill insurance for these interactions. There are specific exclusions listed below that will not be billed to your insurance. 

Please note that portal messaging is not a substitute for an office visit. If you find that your message requires several paragraphs to explain a condition or concern, we kindly ask that you call our office to schedule an appointment instead. This will help ensure your concerns are addressed appropriately and comprehensively. Exceptions will, of course, be made when necessary.

We appreciate your understanding as rising operational costs, especially in California, make it necessary to adapt in order to continue serving your family for years to come. Depending on your insurance plan, co-payments, and deductibles, portal messages that result in billing may lead to personal costs ranging from $15 to $25. 

To help minimize unnecessary charges, we encourage parents to utilize our website, which provides treatment recommendations (including medications) for a variety of common conditions. Additionally, you can visit www.healthychildren.org for trusted pediatric resources. If you cannot find the information you need or prefer to reach out to us, we are always here to help.

Portal Charges (including but not limited to):

• Questions about treating a condition or inquiries that result in treatment recommendations/medical decision making by a provider.
  • Note: If the inquiry leads to an appointment, your insurance will not be billed.
• Requests for results (labs, imaging, etc.) that require further discussion and/or treatment recommendations. 
  • Note: In general we will not bill when simply responding with "all normal". Some conditions may require in-person follow-up.

Please Note:
Charges for forms are separate and are outlined in our Financial Policy. If a message involves completing or processing a form, you will only be billed the form fee, not a portal message charge. 

No Charge for the Following:

• Messages initiated by us.
• Appointment requests.
• Requests for results, if instructed by a provider and the results are normal.
• Follow-up questions related to an appointment within 7 days. If the question is unrelated to the visit reason, a charge may incur.
• Questions about an existing referral.
• Questions resulting in a recommendation to seek care at an urgent care or emergency department.
• As noted above, questions that result in scheduling an appointment will not be billed to your insurance.
• Basic dosing guidance for Over-the-Counter medications

After-Hours Nurse Line Charges
For the past two years, we have partnered with a nationally recognized Pediatric Registered Nurse line to support our families after hours. Initially, Milestone Pediatrics absorbed the cost of this service, as insurance plans do not cover after-hours nurse triage calls. Unfortunately, due to rising costs, there is now a $25 fee for completing a call with our after-hours nurse line.

This fee does not apply if the call is related to a same-day prescription issue or concern from a same-day visit.

We appreciate your understanding as we continue to provide high-quality care and access to professional pediatric advice, even outside of regular office hours.

We are proud to serve your family as one of the only stand-alone pediatric practices in the county. Our goal is to remain a sustainable practice for years to come. We deeply appreciate your understanding and continued trust in our care.

Sincerely,
The Milestone Team