administrative pediatric fees
Administrative Fees

The World of Pediatrics charges administrative fees for services rendered that are not typically covered by Insurance Policies. Administrative fees may also be applied for a patient's failure to comply with office policies and guidelines.

Below is a list of the most typical administrative fees, although, not all inclusive.

Letters, Forms, Medical Records

Letters/Miscellaneous Paperwork

Letters, paperwork, or miscellaneous forms not listed elsewhere will have applicable charges applied for their service preparation. These charges depend on the quantity and depth of forms and documents that a patient requests us to prepare.

If applicable, the cost for notarization of these forms is included. These forms will be ready for pick up or for fax within 7 to 10 days of request. Minimum charge is $5.00, but typical charges are $15.00 to $25.00 each. Charges may exceed these amounts depending on what has been requested and the time needed to complete.

Payment will be required prior to pick-up, mailing, or faxing. If faxing or mailing to an address other than the patient's address of record, we must have a signed consent form.

If mailing, additional mailing fees may apply.

Request for Medical Information to be Faxed or Mailed Form (.pdf) (authorization for us to fax or mail medical information to other parties) can be found under the forms tab on our website.

Forms (Camp, Sports, School):

Due to the increasing demand for forms to be filled out for various school, camp, and sports programs, we have found it necessary to charge $15.00 for each health form to be filled out. If your form is brought in with your child on the day of their well child exam, there will be no charge. We, also, request that all forms be dropped off at least 7-10 days in advance, so that we may have ample time to complete all forms. If not given ample time to complete forms, then additional charges may be applied.

Payment will be required prior to pick-up, mailing, or faxing. If faxing or mailing to an address other than the patient’s address of record, we must have a signed consent form.

If mailing, additional mailing fees may apply.

Request for Medical Information to be Faxed or Mailed Form (.pdf) (authorization for us to fax or mail medical information to other parties) can be found under the forms tab on our website.

Medical Records Transfer/Copy

If requesting your child’s medical records, please, allow two weeks for our office staff to process your request. There is an administration fee of $25.00 per chart, for the first 25 pages, and $0.85 per each additional page up to 50, $0.35 for pages 51-100, and $0.25 per each page over 100. We do not charge an administration fee to send a copy of your child’s immunization record and growth chart to another physician’s office.

Medical Records Transfer Request Form (request from you for your records to be transferred to us from another party) can be found under the forms tab on our website.

Request for Medical Information to be Faxed or Mailed Form (.pdf) (authorization for us to fax or mail medical information to other parties) can be found under the forms tab on our website.

Notary Services

Notary services are available. These services are free regarding paperwork that requires Dr. Lyudmila Vayman’s signature be notarized or paperwork specific to an actual office visit or consultation.

Notary services not performed for paperwork generated as part of the normal course of The World of Pediatrics business will be subject to a $20.00 charge per page.

Returned Checks

In the event a personal check is returned unpaid from the patient’s bank, their account will be charged a returned check fee of $25 for each check, and their account may be placed on a “cash only” basis for one year.

Late co-pays

If a co-pay is not paid at the time of visit, a service charge equivalent to your co-pay will be added to your account.

Cancellation or Missed Appointments

Much effort goes into preparing for your visit. If you are unable to keep your appointment, please, be considerate and notify us immediately. Failure to cancel an appointment in a timely manner deprives other patients from being able to be seen during that time and prevents other patients from being seen in a timely manner.

Contact us no later than 24 hours before the time of your scheduled appointment to cancel. All “same day – less than 24 hours” well child visits cancelled without proper notification will be charged $50.00. The $50.00 charge will be due prior to the scheduling of a new appointment.

All “same day” cancellations and “no show” well child appointments will be charged a $50.00 missed appointment fee. Two “unexcused” missed appointments may result in discharge from the practice.

Services Insurances May or May Not Cover

Labs, Screenings, Diagnostic Procedures

Insurance policies may or may not cover labs and screenings drawn or performed in the office. Insurance may or may not cover particular labs, screenings, or diagnostic procedures ordered by Dr. Vayman regardless of where they are performed. Fees not covered for these services will be the patient’s sole responsibility.

It is the patient’s responsibility to know what lab company that their insurance requires them to use and any special conditions that they require them to follow.

Telephone Consultations

Insurance policies typically do not cover telephone conferences with physicians to discuss problems or medical issues. Fees not covered for these services will be the patient’s sole responsibility.

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3005 Royal Blvd. S., STE 110, Alpharetta, GA 30022
Office Hours Monday through Friday 9:00am - 7:00pm, Saturday for sick only 10:00am - 12:00pm
Call 770-442-5437 for an Appointment
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