Seeing your child for their well exam every year is extremely important to monitor their growth and development. Younger children should maintain their appointments because it is essential to continue their immunizations. Older children must also be seen to monitor their growth, but in these challenging times, to also check on their mental health and well-being.

Here, at Carmel Pediatrics, we are doing everything we can to keep a safe and healthy office. When you arrive for your appointment, we are asking you to contact our office from your vehicle so we can verify insurance. We will then let you know when your exam room is ready. We are currently not using our lobby, so you will not experience any contact until you reach your exam room. We are also deep cleaning the exam rooms after every patient. Once you enter through Entrance 3, hospital personnel will be manning a screening station, and they are not allowing anyone into the building who have a cough and/or fever.

We are only seeing sick children via telehealth, so only well children will be in our office. We firmly believe that our office is safer than many other public spaces. Well exams are a vital part of a child’s development, so please call or text us to schedule your visit.

Dear Patients and Parents:

Sincerely,

Carmel Pediatrics, LLC

Dear Families,

As we have mentioned over the last couple of weeks, we have been looking at all of our processes to ensure we are providing the safest environment for our amazing patients and team. Per new guidelines, we have made some difficult decisions to alter our daily hours here in the office.

All of our physicians will continue to work their normal days; however, the hours we will see patients have changed. We will start our day with well exams for young patients who require immunizations. We will take a short break to clean our exam rooms and lobby, and then we will see sick patients until we are finished. This means we will most likely close our office early every day. If your child is over the age of two, we will be contacting you soon to reschedule your appointment out by 60 days.

This new schedule will begin on Monday, March 23, 2020.

If you receive the “we are closed” recording when you call our office, that means we are closed for the remainder of the day. You are welcome to call your physician (their number is listed in the phone recording) after hours should you have any questions.

We understand this new schedule may inconvenience some of our patients, and we sincerely apologize. Our sole focus is to ensure we are keeping our patients and staff safe by limiting exposure.

OTHER NEWS AND NOTES

• As a reminder, morning phone time to contact the physicians is between 7:30-8:00 am. If you do not know your doctor’s phone number for after hours, please call 317-582-7257 and listen to the recording.
• Since we are located in the Ascension-St. Vincent Hospital building, visitors are being restricted by Ascension to ensure the building is safe for employees and patients. Visitors are no longer allowed to use Entrance 4. If you are coming to our office, please use Entrance 3. There will be nurses positioned inside the entrance to screen all visitors. They will allow for two parents to accompany your child; however, we do not advise that you bring any other children at this time. Their normal protocol only allows for one parent to attend; however, they have made a special exception for Carmel Pediatrics’ patients.
• As additional tests are made available, there may be an increase in positive COVID-19 cases across the nation. Please do not let this alarm you. We note, however, that testing is still currently not widely available, and we do not have testing capabilities.

We are a family here at Carmel Pediatrics, and we will get through this together. We will continue to communicate new guidelines as they become available. Remember, if you have not followed us on Facebook, yet, we highly recommend it, as we are posting updates and tips daily.

Sincerely,

Carmel Pediatrics, LLC

Dear Families:

We wanted to reach out to you to give you a few updates regarding the COVID-19 (Coronavirus). We last emailed you on March 5, 2020 with some general information regarding the virus and what you should be doing to protect you and your family. Today, we want to give you a few updates on what we are doing as an office. Please know that this is a very fluid situation, that what we are doing today may very well be different tomorrow. The physicians are meeting every morning to review any new guidance from the CDC and Indiana State Department of Health and to discuss any changes that might be necessary to protect you, the patient.

If you have not done so already, please like us on Facebook. We are using Facebook as a major form of communication for updates on what we are doing here at the office. You can find us by clicking here.

We are asking every patient who walks into our office if he or she has traveled out of the country within the last 14 days. If they have, we are taking necessary precautions. Please let us know as soon as possible if you have traveled to an area that has a higher risk.

If you have general COVID-19 questions, please go to CDC.gov or to our website (CarmelPediatrics.com) for more information. We kindly ask that you do not call the office. As much as we would like to answer your questions, we need to ensure our nursing resources are being applied to sick children. The CDC is going to have the most up-to-date information to keep you informed. Of course, we will continue to stay on top of the information and make sure you are notified as necessary.

We have had a lot of questions from patients asking to be tested for COVID. It is important to note that hospitals are not testing everyone. The Indiana State Department of Health (ISDH) has a VERY limited number of tests for COVID, and we do not have any tests (nor do we expect to receive any). Currently, the testing is only being performed at hospital emergency departments in the area. However, they are being extremely selective as to who is tested. You have to check off several boxes before the ISDH will allow the emergency department to test an individual.

We have also taken necessary precautions in our office to keep a sanitary and safe environment. We have removed the drawing areas and books from the lobby. We understand that your children will be bummed (and we are, too), but the health and safety of those in our office is our number one concern. We have created a “well” and “sick” area within the lobby as well. While our lobby is small, our hope is to at least try to limit exposure. Parents, if you have a sick child, please make sure they stay in the designated area. We appreciate your assistance with this.

Masks are available for patients who are sick. Unfortunately, with the severe shortage of masks available to the public for purchase, we have to limit who we make those available to. We sincerely apologize for the inconvenience this may cause.

While we always clean rooms to specific standards, we are taking our cleaning habits to the next level to ensure we are protecting everyone involved.

Thank you for your assistance and patience with us as we navigate this difficult time. We are here for you if you need us, and we will do everything in our power to ensure you have all of the resources to keep your child safe.

Sincerely,

Carmel Pediatrics, LLC

Dear Families:

Over the past several months, the COVID-19 (coronavirus) has been spreading across the world, originating in China. The physicians of Carmel Pediatrics have been closely monitoring the situation, and we felt it was necessary to reach out to you to share what we know. As of today, the risk to you or your children of contracting the virus is slim. Early studies are also showing that this particular virus is not affecting children as much as older adults, and the children who have contracted it experienced mild symptoms.

Understanding the virus and how it affects us is important. We will continue to provide you with updated information as it becomes available. We have updated our emergency procedures and have supplies on hand in the office should the virus be present in our area. Due to shortages in masks, we will only provide masks to sick children.

The Centers for Disease Control and Prevention (CDC) recently published a FAQ to help us understand the basics of the coronavirus:

What is coronavirus disease 2019 (COVID-19)? COVID-19 is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China.

How does COVID-19 spread? The virus that causes COVID-19 probably emerged from an animal source, but now it seems to be spreading from person to person. It’s important to note that person-to-person spread can happen on a continuum. Some diseases are highly contagious (like measles), while other diseases are less so. At this time, it’s unclear how easily or sustainable the virus that causes COVID-19 is spreading between people.

What are the symptoms of COVID-19? Patients with COVID-19 have had mild to severe respiratory illness with the following symptoms:

• fever
• cough
• shortness of breath

How can I protect myself? The best way to prevent infection is to avoid being exposed to the virus that causes COVID-19.

There are simple, everyday preventative actions to help prevent the spread of respiratory viruses. These include:

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.

If you are sick, to keep from spreading respiratory illness to others, you should:

• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue is not available, cough/sneeze into the inside of your elbow, not your hand.
• Clean and disinfect frequently touched objects and surfaces.

What should I do if I recently traveled to China or other affected countries and got sick? If you were in China or other affected countries and feel sick with fever, cough, or difficulty breathing, you should seek medical care. Please contact our office to inquire about what to do next. We will give you instructions on how to receive care without exposing other people to your illness. While sick, avoid contact with people, stay home, and delay any travel to reduce the possibility of spreading illness to others.

What if I have an upcoming vacation planned? If you are traveling to China or other affected countries, please check with the CDC website for an updated list of countries that have travel advisories. If you are traveling to areas that are not currently affected, it would depend upon your personal risk tolerance. This is a decision only you can make.

Is there a vaccine? There is currently no vaccine to protect against COVID-19. The best way to prevent infection is to avoid being exposed to the virus that causes COVID-19.

Is there a treatment? There is no specific antiviral treatment for COVID-19. People with COVID-19 can seek medical care to help relieve symptoms.

If you have further questions, do not hesitate to call the office and ask to speak with a nurse. Bottom line, you do not need to panic.

For the Children,

Randall D. Stoesz, MD

Susan L. Davis, MD

Carolyn O. Robinson, MD

Anna G. Gilley, MD

Elizabeth J. Beach, MD

In this issue:

• Carmel Pediatrics Structural Change and What it Means to You
• Insurance Marketplace Open Enrollment and Accepted Plans
• Office Holiday Hours
• Flu Shots

Carmel Pediatrics Structural Change and What it Means to You

For 31 years, we have billed each of our doctors under their own, separate Tax ID Number (TIN). While this structure is not wrong, this has certainly created some challenges for us over the years. Another way to look at it is each doctor had their own business within Carmel Pediatrics. So, say for example that you saw two different doctors for sick visits, and you ended up having a balance with each. You would have to pay each doctor in two different transactions. You would receive two different statements. Obviously, for you, this can be cumbersome and confusing at times.

Beginning January 1, 2019, we will begin to bill all five of our doctors under one, single TIN. Basically, we have combined all of the doctors under the Carmel Pediatrics, LLC umbrella. This will make the lives much easier for the billing team. However, what does this mean for you and how does it affect you? Here are a few items that you will need to know:

• We have spent the last six months re-credentialing with insurance companies (which has been oh-so-much-fun). While we are not anticipating any problems with claims billed in 2019, there are always bumps in the road whenever a major change is made. We are asking you to be patient with us if any problems do arise. If there are any problems with any of your claims, we will be very transparent with you so you know what is going on. Our biggest fear are those smaller insurance companies. We are confident, however, that we have covered all of our bases.
• You will receive one statement per month, regardless of which doctor you owe. When calling in payments, we will only have to run your credit card once. Our online bill pay system will change — you will not have to select a doctor to pay anymore. That’s pretty awesome.
• If you are currently on a payment plan, we will be contacting you to set up a new payment plan, as the old payment plan will be null and void. We apologize for the inconvenience this may cause. Payment plans will be easier in the future, especially if you owe multiple doctors.
• If you had set up accounts on the online bill pay system, those will be null and void as well. Your unique online bill pay code will also change. When paying any balances in 2019, just make sure you pay attention to that online bill pay code on your statement, and you should be fine.

If you have any general questions or about how this might affect you, please don’t hesitate to contact Nick Hannah, Director of Operations, at 317-582-7875.

Insurance Marketplace Open Enrollment and Accepted Plans

We have received a few questions lately about Ambetter insurance plans on the ACA Marketplace. None of our physicians are showing up in the 2019 list of doctors accepting Ambetter. This is not accurate. We believe this might be due to the new TIN change and credentialing process. We are currently working with our representative from Ambetter to get this fixed. Rest assured, we will be taking Ambetter in 2019, so if you have the insurance or are thinking about purchasing a policy through Ambetter, you are will continue to have a place in our family. We also accept Caresource on the Marketplace.

As a reminder, the final day of open enrollment for policies on the Marketplace is Saturday, December 15, 2018. Open enrollment for company based policies should be ending soon, too, so be sure to check with your HR team if you have any questions about your policy.

Holiday Office Hours

We will have slightly different hours during the holidays later this month. Please be advised there will be some days where we will only be here for half a day, seeing sick call only. So, if you have a sick child, please be sure to call first thing in the morning at 8:30 a.m. to ensure your child is seen that day. The schedule depends upon the doctor that is in that day, so be sure to call us before coming to the office if you need to pick up something. The phone recording will always be changed to let you know if we are closed early. If you need to reach a doctor after hours, the doctor’s phone numbers will be listed on the phone message. We typically close early on Christmas Eve and New Year’s Eve, but there may be others.

We will be CLOSED on December 25th and January 1st.

The relationship between physician and patient is very important and can be personal. We want you to be able to connect with your doctor at a personal level to create a lasting relationship. In this edition of our blog, we asked Dr. Stoesz several questions about his personal life so you can get to know him better. Enjoy!

Why did you become a pediatrician?

“I have always been drawn to children. During medical school, I was rotating through obstetrics. A baby was delivered, and I was supposed to be paying attention to the mother, but I realized I wanted to be with the baby. A that moment, I decided to be a pediatrician.”  

What do you love the most about your family?

“Our family values of helping other and creation care.”

Tell us something about yourself that makes you unique.

“I am a volunteer ‘tree steward’ for the city of Indianapolis. This allows me to help provide the trees of our community the best care possible.”

What is the coolest/most unique thing you have ever done?

”I spent a week on Budapest, Hungary helping build a house for Habitat for Humanity with my father, brother, and President Jimmy Carter.”

What is your ideal vacation?

“I enjoy active vacations within nature or in a different culture.”

What do you like to do during your free time?

“Family time is my #1 priority, as my wife and kids are everything to me. I love bicycling, as I even bicycle to the office when the weather is nice. Woodworking is a passion of mine. I enjoy seeing a piece of wood become something. Finally, I enjoy cooking!”

If you had to pick one word to describe yourself, what would that be?

“Intuitive.”

What makes Carmel Pediatrics special to you?

“Great people with a shared mission to provide quality health care to children and their families.”

Is there anything else you would like to share about yourself?

“I have a passion for proving care for children with disabilities.”

The American Academy of Pediatrics (AAP) has recently updated its recommendations regarding rear-facing car seats. The AAP is always stated that infants should be in a rear-facing car seat, but they have now extended that recommendation to children for as long as possible, or until the child reaches the highest weight or height specified by the car seat manufacturer. I have provided you some links for more information on the new recommendation. Of course, if you have any questions, please do not hesitate to reach out to us at 317-582-7257 and ask to speak with a nurse.

Links:

How long should my child ride rear-facing?

Car Seats: Information for families

The 4th of July can be a fun time of year for families; however, it can also be dangerous. Carmel Pediatrics wants you to have fun, but we also want you to be safe.

Thanks to the American Academy of Pediatrics, click here for some tips on how to stay safe this year.

Of course, give us a call at 317-582-7257 if you need anything.