Welcome to your Pediatric medical home!

Patient Information

We welcome new patients to our practice serving Nashville and north, and will be glad to schedule a new patient visit. This visit includes more time for introducing you to our practice and  reviewing your child’s medical  history and is usually not scheduled on an urgent basis. If you have been assigned to our practice by your insurance plan, please call an schedule a new patient visit as soon as possible.  Please review our Privacy and Financial Policy ahead of your visit.

If you are expecting a baby, our office can schedule you for a prenatal visit with one or more of our pediatricians. There is no charge for a prenatal visit and it is an excellent way to see the office and meet our staff. One of the pediatricians can talk with you about your pregnancy, family medical history, special concerns, and answer any questions you have about our pediatric practice. You will receive printed material about our practice and have the opportunity to briefly meet some of the other doctors. You may choose one of our  pediatricians without a prenatal visit by notifying your obstetrician of your choice.

We care for newborns in the nurseries at Vanderbilt Children’s Hospital, St Thomas Midtown Hospital, and Centennial Women’s Hospital. All of these hospitals have full-time, on-site neonatologists (specialists in sick newborn care) to help your baby in the event of problems during or after delivery. Typically, when your baby is born, your delivery nurse will call the pediatrician of your choice. One of our pediatricians will examine your baby in the hospital within 24 hours of his/her birth and then come to your room to see you, answer any questions or concerns you might have, and give you our newborn booklet. This booklet contains “instructions” for the care of your baby and information about the office. The doctor will visit you and your baby each day to monitor and discuss the infant’s nursery course, including vital signs, feeding, and weight. During the nursery stay the infant’s treatment will include:

  • Vitamin K injection to prevent life-threatening bleeding.
  • Erythromycin eye ointment to prevent bacterial eye infection that can cause blindness.
  • Hepatitis B vaccine to prevent infection that can cause liver failure and cancer (the first of three).
  • Screening blood test for Sickle cell disease, low thyroid hormone, and 20 other diseases.
  • Screening test for High bilirubin (jaundice) that may be followed by a blood test if necessary.

The blood tests are done by pricking the babies heel and collecting drops of blood. If the babies bilirubin is high there may need to be several blood tests done over a period of time and therapy with special lights (phototherapy), requiring a more prolonged nursery stay.

Sometimes other blood tests are required to test for low blood sugar or anemia. If these conditions are suspected or diagnosed, they will be discussed with you by your pediatrician and neonatal nurse.

We will see your baby for the first check-up one to three days after discharge from the hospital in order to support breastfeeding, monitor normal weight loss, and evaluate possible jaundice. We will see you and your baby again at three weeks of age and for subsequent periodic checkups. Our patients come from a wide geographic area in and north of Nashville, so, if your baby is born in another nursery in the area, he/she will be seen by a pediatrician who takes call at that hospital. Please call our office to make an appointment for one to three days after discharge from the hospital.

We encourage breastfeeding because of its many emotional and health benefits. There are many classes and much literature about breastfeeding, so much, in fact, that it seems intimidating. While classes and reading can be helpful, after the baby is born both mother and baby will have time to learn. If there are particular issues then we can refer you to a lactation consultant.

You can view Rivergate Pediatric’s Privacy Policy by downloading the PDF here.   Right click on document to download.

Your Financial Responsibility

A significant part of the trust involved in the Doctor-Patient relationship involves each person fulfilling their responsibilities toward each other. One of the patients, or parents, responsibilities is to pay for services provided.  Please read and be familiar with the policies below.

Payment

Payments may be made by mail or by calling 615-543-2270 or 615-859-6650. Statements with an outstanding balance must be paid on receipt of statement. All accounts over 90 days old are considered delinquent and subject to collection.  We accept cash, checks, debit cards, and all major credit cards

First Visit

New patients are asked to pay on the day of their first visit.  We will try to verify your deductible prior to your appointment to give you an estimate of payment. Insurance co-payments are always due at the time of service.

Deductibles

Until you have met your deductible, we require a $50.00 deposit at each visit.  This deposit does not apply to any previous balance on your account. We accept cash, checks, debit cards, and all major credit cards.

Self-Pay Patients

Payment is required at the time of service. We offer a discount for private pay patients. Established patients who are unable to pay at the time of service should make payment arrangements with the billing department.

Co-Payments

Copayments must always be made when you check in for your appointment. We cannot bill you for your co-payment! Even though your insurance may cover well checkups at 100% a separate copay and deductible may apply if an additional service is provided.  For example, during your child’s annual well checkup our physicians discuss (with you or your child) issues of normal growth, development and wellness. They will review family, medical and social history, perform a complete physical exam and order any recommended periodic screening tests. Your child may have other significant and separate health issues (asthma, migraines) or new acute illnesses that you may want to discuss with your physician on the same day as your checkup. If time is allowed, our doctors are willing to discuss these specific concerns or illnesses at that time so you do not have to schedule another appointment. This may require a separate office visit charge and copayments will apply.

Coordination of benefits

When you have two insurance policies, you will need to inform both insurance companies that there is other insurance so that they can coordinate benefits to determine which should be filed as primary and which one secondary.  The insurance companies will not take the information from us. The insured must call. As a general rule, primary is determined by the birth dates of the insured parties. The birth date that comes first in the year is usually primary. There are other circumstances in the case of divorce and court orders that would change this rule. Your insurance company will tell you what they need. If you have any questions, please feel free to contact our billing and insurance department. We will be happy to do whatever we can to help you co-ordinate your policies to avoid problems with payments.

PLEASE NOTE: TENNCARE WILL ALWAYS BE SECONDARY IF YOUR CHILD IS COVERED UNDER ANY OTHER INSURANCE. FAILURE TO NOTIFY TENNCARE OF OTHER INSURANCE COVERAGE IS CONSIDERED FRAUD.

Insurance Plans

We will bill your insurance plan or provide a form for you to file. You will be billed for any balance due (deductible, non-covered services) after the claim is paid by your insurance company. All balances are due when statement is received. You are responsible for any and all co-payments, deductibles, and co-insurance. You are required to provide us with complete insurance information on primary and/or secondary coverage. We will ask you to update your insurance information at each visit. You need to understand your insurance plan. All medically necessary care may not be covered.  We have experienced insurance staff who can help answer your questions, or you can get help from your plan sponsor (employer) or the insurance plan itself.  We currently have affiliations with the insurance companies listed below. We will use our knowledge and experience to help you understand the terms of your coverage, but it is your responsibility to be familiar with the details of your policy, and be responsible for payment. Even if your insurance company appears on the list below, please call the billing and insurance department at (615) 543-2270 to ask our insurance specialists if we participate in your insurance plan.

  • Aetna
  • Amerigroup
  • United Healthcare Community Care
  • BlueCare (ages 0-1)
  • Blue Cross/Blue Shield  (Networks S, P, E, TennSelect)
  • Cigna Healthcare
  • Great-West
  • Humana Choice Care
  • Humana Tricare (Standard Only)
  • Multiplan/PHCS
  • United Healthcare
  • Bright Health

Non-covered services 

Most insurance plans cover annual physicals (well care) and some of the recommended screening tests (vision, hearing, developmental and emotional). Some have an arbitrary limit on the number of well visits or they are subject to a deductible or not covered at all.  Some may not cover immunizations.  Although we try to be aware of insurance policy restrictions on covered care, we must continue to provide quality care and you may be responsible for the uncovered costs.  If immunizations are not covered, you may consider obtaining these at your local Health Department at a reduced price or free based on income. We participate in the Vaccines for Children Program which provides vaccines for Medicaid and uninsured patients under the age of 19. Uninsured patients aged 19 and older may receive recommended vaccines at no or reduced coast at the health department. Please check with your local health department for availability, appointments and requirements

Newborns

Please contact your insurance company or employer to enroll your newborn on your insurance policy. Most insurance companies require this to be done within 30 days of birth. Failure to enroll your child within the guidelines of your insurance policy can result in “late enrollment” provisions. This could reduce your benefits or cause a break in insurance coverage for the newborn. If you have any questions, please contact our insurance department. If you have any denied claims, please contact the insurance company or call us when the child is added so that we can resubmit claims.  Sometimes a child is covered under the mother’s policy for the first 30 days, even if you do not enroll the child under that plan. Please bring it to our attention if there are two different policies at any time. We will be happy to do whatever we can to help you coordinate your policies to avoid problems with payments so that we can coordinate the coverage to prevent duplicate payments.

REMEMBER: BY LAW, TENNCARE WILL ALWAYS BE SECONDARY TO ANY OTHER INSURANCE. YOU MUST PROVIDE US WITH ALL INSURANCE INFORMATION

Other Charges

Forms:   No charge for immunization forms.

Special Forms (camp, sports, special olympics): No charge for one form per year

$20 charge for Family Leave Act form or Letters of Professional Opinion

Returned Check Fee: Managed by Check Velocity 1-800-320-8545

Medical Record Charges: Medical Summary – No charge

Copy of Record: $20.00 for first five pages, then $0.50 per page

For Billing and Insurance Questions

615-543-2270

877-467-6565 (toll free)