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What to Expect in 2019

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.

Getting to Know the Doctor: Randall D. Stoesz, MD

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.”

New AAP Guidelines for Rear-Facing Car Seats

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

4th of July Safety Tips

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.

Getting to Know the Doctor: Dr. Robinson

Getting to Know the Doctor:
Dr. Robinson

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. Robinson several questions about her personal life so you can get to know him better. Enjoy!

Why did you become a pediatrician?

“I was a camp counselor at Camp Riley, when I was in undergraduate school, and I fell in love with the kids there.”

What do you love the most about your family?

“As a whole, we love doing outdoor activities together and traveling to new places, and we are also open to new ideas and adventures.”

Tell us something about yourself that makes you unique.

“I recently became interested in participating in sprint triathlons because my husband loves to do them. I am training in some capacity.”

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

One of the coolest things I have ever done was hiking in Nepal with the views of Mt. Everest and the Himalayas off in the distance, as well as meeting the amazing people of Nepal. It was also entertaining to see the yaks loaded down with supplies and to hear their bells signaling their approach.”

What is your ideal vacation?

I would say any trip that requires hiking and exploring, being exposed to new places and cultures.”

What do you like to do during your free time?

“I spend much of me free time gardening. I love tending to the plants and preparing and serving the vegetables that come from my garden. When I can’t garden, I love to read.”

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

“Active. I am not very good at sitting still.”

What makes Carmel Pediatrics special to you?

“Our staff and the obvious commitment they each feel to providing excellent care to patients, and their ability to care for ALL families.”

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

I believe it is important to always learn, and each day in my office is an opportunity to learn from patients and their families.”

CDC: Why We Should Vaccinate Children

The doctors here at Carmel Pediatrics are firm believers in the overall safety of vaccinations. The Centers for Disease Control and Prevention, with the assistance of the Academy of Pediatrics, wrote a very informative article, The Childhood Immunization Schedule.

Click here to read the article.

For an official statement from the Carmel Pediatrics’ physicians relating to why vaccinations are safe and important for your child, please click here.

Carmel Pediatrics Welcomes

Dr. Gilley and Dr. Beach are pediatric board certified and fellows of the American Academy of Pediatrics. In the tradition of Carmel Pediatrics, they both completed their residency training at Riley Hospital for Childrenin Indianapolis and have the experience to provide primary care for babiesborn premature and childrenwith complex medical needs. As both mothers of three, they also bringwhat they have learned through their ownparenting journey. They look forward to meeting your family and continuing Carmel Pediatricsrole as a guidein your child’sgrowth and development and inbuilding the groundwork for a lifetime of healthy living.

dr-anna-gilley-carmel-pediatricsDr. Anna Gilley, M.D., FAAP

Dr. Anna Gilley, originally from Texas, has been in Indiana since 2002. She graduated from Indiana University School of Medicine in 2006 and completed her residency training at Riley Hospital for Children, including an additional year as chief resident. She worked as a pediatric hospitalist for two years at Hendricks Regional Health Hospital and then settled with her husband in her husband’s hometown ofJasper, Indiana. She practiced general pediatrics forfour years in Jasper prior to their family moving back to Indianapolis. She and her husband, David, a urologist, live in Indianapolis with their three children ages 6, 4 and 2. Dr. Gilley enjoys spending time with family, reading, and traveling.

dr-elizabeth-beach-carmel-pediatricsDr. Elizabeth Beach, M.D., FAAP

Dr. Elizabeth Beach is an Ohio native. She completed her undergraduate education at The Ohio State University and medical school at the University of Cincinnati College of Medicine. She moved to Indianapolis in 1998 for her pediatric residency training at Riley Hospital for Children. She has practiced both as a pediatric clinical educator for the St. Vincent Indianapolis Residency Programs and in primary care pediatric practices for Community Hospitals on the northeast side of Indianapolis. She is married to Dr. Jeffrey Beach of Northside ENT in Carmel and they have three children ages 9, 12, &14in Carmel Clay Schools. She is pleased to be joining a practice in their homeCarmel Community. Dr. Beachenjoys helping atschool, church, and with coachingtheir children’s sports teams. The Beach family also enjoys adventuring outdoors and never misses cheering on their Buckeyes!

As Dr. Miller, Dr. Gilley and Dr. Beach will be available to answer parent calls from 7:30-8 AM and see newborns at IU North and St. Vincent Carmel and St. Vincent Indianapolis Hospitals. When calling to make your next child’s appointment our staff will assistyou in establishing Dr. Gilley or Dr. Beach as your family’s new pediatrician. It is our hope to make this transition as easy as possible and you continue your trust in Carmel Pediatrics for your child’s health care needs.