Frequently Asked Questions
Do you take insurance?
We operate a Direct Primary Care Practice model in order to provide exceptional service to our patients. This means we take payment directly from our patients for our medical services. We do not bill any third party, and we do not “take” insurance (Dr. Riley does not contract with any insurance companies and will not submit claims to your insurance for reimbursement). Many of our patients still carry private insurance.
Are there any restrictions on who can be a member of your practice?
At this time, we are able to take patients who have most types of insurance and all those who are uninsured. However, it is always important to contact your health insurance company for further details regarding having a “direct primary care” physician. Specifically, if your insurance company might be able to reimburse the monthly fee paid to Dr. Riley Pediatrics.
How much does membership cost?
Cost depends on the age of your children, and discounts are given for families with more than one child enrolled. See our Enrollment page for the general fee structure.
How can I enroll my child in the practice?
Dr. Riley meets personally with all the prospective families who are interested in joining! Please fill out our enrollment form here and we will contact you to set up an in home meeting with Dr. Riley.
How will my membership be billed?
Membership fees are charged monthly to your bank account (preferred) or to your credit/debit card. If your bank account has not been verified and payment isn’t made by your first visit, you will be asked to pay via credit or debit card on the day your child is seen.
What is not covered by my membership fee?
- Specialty visits, hospital stays, ER visits, urgent care visits, etc: Any medical services from other medical providers will be billed to your insurance by those providers.
- Out-of-office procedures, imaging, or labs: These, too, can be billed to your insurance by the office administering these services.
- Vaccines are not covered by your membership fee and will be billed to your insurance (or you will provided a superbill to submit to your insurance for reimbursement).
Do you administer vaccines? What is your position on vaccines?
We are contracted with third party company (Vaxcare) to provide vaccines to our patients who have private insurance, and have those vaccines billed to the insurance company. At this time, we do not plan on participating in the VFC (vaccines for children, this could change soon) program and patients who are uninsured will be encouraged to get their vaccines at the County Health Department. We encourage all of our families to vaccinate their children according to the schedule recommended by the AAP. We believe that vaccines are modern medicine's most important contribution to both the health of individuals and populations. However, we respect a parent's right to make medical decisions for their children, and will work with families who desire to follow an alternative vaccine schedule, after we have been able to discuss their concerns together.
Is Direct Primary Care insurance?
No. DPC is not analogous to an insurance plan. We recommend that everyone continue to carry an insurance plan or health-sharing plan to cover significant medical costs that can be incurred through moderate to severe illness or injury, such as a trip to the ER.
What is your practice philosophy?
We see our relationship with our patients as an equal partnership. Dr. Riley contributes her medical knowledge, combining this with the parent’s knowledge of their child, to make the best decisions together to enhance your child’s overall health.
Do you offer free prenatal/meet and greet visits?
Absolutely, in fact we meet face to face with everyone who is interested in our practice to determine if it would be a good fit. Please fill out our pre-enrollment form and we will contact you to set up a prenatal visit at no cost.
Do you offer house calls?
We want to offer mostly home visits. We believe it is best for the family and child. Well child visits can also be conducted at home but if vaccines or screening labs/exams where extra equipment is needed we will request that one visit be in office. Dr. Riley feels it is very important for all newborns and infants, from birth till 3 months old, be seen at home for both well and sick visits so they are not exposed to other sick children among other convenices this allows for in our youngest members. Many issues can be handled via phone, video chat or messaging and will be determined by the family and Dr. Riley based on the child’s needs. If you have a question, that is what we are here for.
Do you see patients who are not members of the practice, on a fee for service basis?
For a short period of time, as our practice grows, we will see children who are not members of our practice on a fee-for-service basis. The duration during which we will offer this and the associated fees will be posted on our website (details to come by early Feb 2020 or sooner). Further inquiries regarding this should be submitted via the pre-enrollment form and we will get back to you shortly. If you are a member and have a child visiting you from out of town who is a relative or friend, we can see them schedule permitting. Contact Dr. Riley by text message or email (all direct contact methods for Dr. Riley to be outlined and detailed by Feb 1, 2020).
What happens when Dr. Riley goes on vacation?
When Dr. Riley goes out of town, most often she will still be able to provide care via telephone or electronic means. If your child experiences a truly urgent medical issue they may need to be seen at urgent care/walk-in clinic or the ER. If Dr. Riley goes out of town and does not have adequate access to cell coverage or internet service, coverage for the clinic will be provided by another board-certified pediatrician and our members will be notified via the website, Facebook, and email at a minimum of 2 weeks in advance. In most instances, we will give our patients > 3 months advance notice of any upcoming vacations or other plans (whether or not cell or internet coverage is adequate) to ensure there is no interruption in your child’s health care.
What if my child gets sick when we are out of town?
Given the small size of our practice, your doctor will have the benefit of knowing your family well and of knowing your child and his/her medical history. So we will do as much as we safely can via phone, text and video. This long-distance care may include calling in a prescription to a local pharmacy or helping you find a local urgent care or ER should further evaluation or testing be required.
What if I decide to leave the practice?
If you decide to cancel or terminate your membership, there is absolutely no fee or penalty. We will ask you to give us 30 days advance notice of your cancellation in writing. If you want to rejoin the practice and there is an open spot, a re-enrollment fee will be required.
What days and hours does Dr. Riley Pediatrics offer her services in the home or the office?
Availability will be very flexible and parents will be able to schedule same-day/next-day appointments or future well child visits online via our electronic health system. There will be appointments available Monday-Sunday, as determined by the patient’s needs, the season, and Dr. Riley’s schedule. Parents will be encouraged to check the online schedule and available times when an appointment is needed.