If you have a medical emergency, please call 9 1 1. If you are having trouble contacting us via the patient portal, email or have not received a response to a message, please call our office at 614.459.4200.
Thank you for considering Dr. Carine for your integrative pediatric needs. We are sure you have questions and we would like to help any way we can, just read below or call us at 614.459.4200 for information about becoming a patient!
If you want your child(ren) to become a new patient, please first send us your insurance card(s) for approval. With all the changes in health insurance we require copies (or pictures) of all primary, secondary and/or Medicaid insurance cards (front and back) PRIOR to any forms being completed. Please do not exclude ANY insurance information, we cannot advise you if we are not fully informed. We cannot schedule any visits until we have completed forms on file. IF/when we approve your insurance, you may complete the corresponding patient forms provided below and send them to our office!
New Patient Registration with Detailed History - for children over the age of two or any child with a extensive health history.
New Patient Registration - for children under the age of two.
Pro Parent Form - for parents expecting their first child.
Transfer Records TO Our Office - for releasing records from your current office, specialist or hospital to our office. Please be sure to detail any specifics necessary on the form.
2016 Vaccine Policy - already included in the above registration packets, this is for your reference.
You can return the completed paperwork to our office in whichever manner is most convenient to you, using the following contact information:Dr. Carine Integrative Pediatrics 3300 Riverside Drive, Suite 200 Upper Arlington, Ohio 43221 Phone: 614.459.4200 Fax: 614.459.1589 Email: email@example.com Shop Supplements Online: www.purelyintegrative.com
We ask this to streamline the process of billing, registration, and scheduling. Once we receive your information in our office we will register your child(ren) and we will call you to schedule. Feel free to call and confirm we received the paperwork, however, it can take 2-5 business days to get your paperwork reviewed and set up in our system. Thank you in advance for your cooperation!
Please note Dr. Carine no longer performs ANY Well Checks. ALL Well Checks will be scheduled with one of our wonderful Nurse Practitioners. We understand this is not for everyone, if you are someone who wants the Well Checks to be performed by the doctor, you will wish to find another office for your Primary Care needs.
HAS YOUR INSURANCE CHANGED?
PLEASE update our office immediately by faxing or emailing us a copy (front and back) of your new insurance card(s)!
We accept most of the big name insurance companies, but urge families to:
Email/Fax us copies (front and back) of your primary, secondary, tertiary and/or Medicaid insurance. Without ALL of your insurance information, we cannot properly inform you. In addition, you should call your insurance (or check online) to see if your particular plan lists us as an “in network” provider. When you find us listed on a particular plan, or call your insurance to confirm that, we recommend documenting the date, time and representative you speak with.
With all the health care changes, we know families who have had “out of network” coverage by the time their paperwork was complete, even though we were “in network” when they began registration with their insurance provider.
If you are interested in becoming a new patient you MUST send us your primary insurance card (front and back). If you have ANY secondary insurance, you must also send us a copy (front and back) of that card. Please do not exclude insurance information for ANY reason.
**A note about insurance:
It is the patient’s responsibility, at all times, to know their insurance policy. Patients should be aware of their benefit coverage: including which physicians are contracted with their plan, covered and non-covered benefits, authorization requirements, and costs share information such as deductibles, co-insurance, and co pays. If you are not familiar with your plan coverage, we recommend you contact your carrier directly.
It is the patient’s responsibility, at all times, to provide us with accurate billing information for each family member at the time of service.
If your insurance company requires you to choose a primary care provider (PCP), it is the patient’s responsibility, at all times, to notify them prior to your visit to ensure that you have authorization for your visit with us.