Office Hours and Appointments

In Touch Pediatrics and Lactation, PLLC (to be referred to as ITP subsequently) sees patients via home visits and telehealth and does not have a physical office space.  Generally, appointments will be scheduled between 9am-4pm, but earlier morning or evening appointments will be available by request or if deemed medically necessary by Dr. Rubin.  During office hours, you can expect to get a response the same day to phone calls, e-mails, and texts.  Non-urgent e-mails, texts, and phone calls sent outside of these hours will be handled on the next business day.  You will always be able to reach Dr. Rubin for urgent medical issues via the instructions provided by Dr. Rubin at the time of enrollment, and can expect a response within 30 minutes for urgent messages, even overnight and on weekends.  If you do not receive a response in this time frame, please call again.  Dr. Rubin will either be able to handle your child’s problem via phone or telehealth, or she will arrange an after-hours home visit or refer you to an Urgent Care or Emergency Room if she feels the situation warrants this.  If your child is experiencing a medical emergency, do not call the Clinic.  Please call 911 or proceed to your local emergency room. 

Dr. Rubin will make every attempt to see sick patients within 1-2 days if needed, via telehealth or in-person.  She will make every attempt at arranging an in-person initial sick visit, but at times this initial visit may need to be done via telehealth, in which case a timely follow-up in-person visit will be arranged if needed.  

FEES

Memberships will be paid monthly, with the registration fee and first monthly payment made on or before the first date of service.  We request that payment be made via Zelle (drrubin@intouchpeds.com), cash, or check in order to keep our rates low.  There will also be an option for paying by credit card if necessary.  We will set up automatic billing and payment at the time of registration, with invoicing on the 1st of each month.  The tiered fees are as follows:

Enrollment fee:  $150 per family at time of enrollment of first family member (non-refundable)

Ages 0-6 months:  $200/month

Ages 6 months - 5 years:  $150/month

Over 5 years:  $125/month

There may be occasional nominal fees for lab work (point of care testing), imaging or other diagnostic tests, or treatment supplies that will be disclosed at the time of service. 

ITP reserves the right to make adjustments to the above membership fees at any time, with 60 day notice to members. 

If a monthly bill is not paid within 2 weeks of invoice delivery, we will send you a reminder.  If an automatic payment is declined for any reason, you will be notified and we will expect payment via an alternate payment option promptly.  If this payment isn’t made, we will send monthly reminders and after the third reminder, if your account has not been paid fully, we will cancel your membership (with 30 days notice) and send your bill to collections.   If you are having special unexpected circumstances leading to non-payment, please let our office know so we can figure out a payment plan.  We do not want to have to send anyone to collections!

Insurance

Members must understand that ITP is not a form of insurance.  Additionally, we do not accept or bill health insurance.  We may ask for your insurance information in order to pass it along to 3rd parties providing services for you (i.e. vaccines, lab work), and those 3rd parties will handle billing for insurance for those specific items.  You may want to talk to your insurance company to discuss out-of-network benefits as some of these 3rd parties may be out-of-network.  You may also want to talk to your Health Savings Account (HAS or FSA) manager to determine if your membership fees would be considered a coverable service (many will cover it but you should refer to it as “recurring charges for physician services,” not a membership). 

Cancellation policy

Membership can be terminated by either party at any time without cause, with 30 days’ notice*.  If ITP cancels a membership, we will continue to provide urgent medical care until 30 days after notice is given, with no reimbursements for that period of time.  If the member cancels, services will be provided by ITP until the end of the current paid month, if desired by the member.  No reimbursements will be made, except for those who have prepaid for an entire year, in which case payment will be reimbursed at a pro-rated amount calculated from the last day of the month during which the cancellation notice was made.  We will be happy to forward your records to your new provider upon request. 

There will be a $350 fee for re-joining the practice after canceling, unless there is a mutually agreed-upon break in patient membership for extenuating circumstances with the intent to restart when able (for instance, if a family is moving out of the area for a year and wants to cancel membership during that time, but plans to re-register upon return to the area).  Unpaid breaks in membership will not be offered for short-term vacations.  Please contact the practice if you are experiencing any extenuating circumstances that you would like to discuss. 

*       The exception to this policy is for memberships from 0-6 months of age.  For this age group, we require a 6-month membership commitment due to the significant amount of care and time typically provided during these months. 

Vaccines

We are still working out our method of obtaining vaccines to be administered during home visits.  Dr. Rubin will update you as she gets more information.  Every attempt will be made to provide your child with routine vaccinations during home visits after we open, but there may be delays in setting this up.  If that occurs, we will recommend that you get your child’s vaccines at a commercial pharmacy such as Walgreens or CVS, the local health department, or at a private physician’s office if you have a relationship.  Any HMO patients will need to have vaccinations administered at the Primary Care Physician’s office.  In addition, wholesale vaccine costs can be paid directly to Dr. Rubin at the time of service. 

We at ITP consider vaccinations as critical for both personal and public health.  Dr. Rubin is happy to answer any questions and address any concerns you may have regarding vaccinations and their safety.  Though Dr. Rubin does use shared decision-making with parents and children in her care for her patients, this is the one area where she does not waiver in her recommendation for getting the vaccines according to the guidelines.  Dr. Rubin follows the CDC’s vaccination schedule.  If you request an alternative schedule, it will be your responsibility to ensure that the vaccines are completed according to your schedule.  Dr. Rubin will not create an alternative schedule for you and will not be held responsible for any missed vaccines or illnesses that could have been prevented had the vaccines been given according to the CDC recommended schedule.  In addition, Dr. Rubin will have a form for you to sign stating that you understand the risks of not vaccinating your child at that visit according to the schedule. 

Labs and other Diagnostic Testing

At this time, any necessary lab work (for preventive or acute care) will be ordered by Dr. Rubin at the time of service and can be obtained at the lab facility of your choice.  There are numerous commercial and hospital lab facilities in the area.  You may want to contact your insurance to see if certain labs are considered in-network as your financial responsibility may be lower if you go to one of these labs.  Any HMO patients will need to have labs done at the facility associated with their assigned Primary Care Physician.  If you choose to use your insurance, billing to insurance will be done by the laboratory directly.  Dr. Rubin has negotiated cash pay rates with a local laboratory – she can provide you with a list of fees if you are considering paying cash and not using insurance (this may be less expensive than using insurance). 

Similarly, imaging or other diagnostic tests will need to be obtained at an outside facility and will be billed to you or insurance directly by the facility.  Dr. Rubin will be happy to take the necessary steps for any prior authorizations needed. 

Communication

The process of communication with Dr. Rubin and ITP will be provided to you in detail upon signing up for membership.  Generally, Dr. Rubin will be using a combination of the Electronic Health Record Patient Portal and an app called Spruce Health, which provides HIPAA-compliant text, fax, and phone communication between physicians and patients.  You will receive a patients-only phone number that you can use to text or call Dr. Rubin for urgent and non-urgent issues, both during general office hours as well as after hours and on weekends.  Generally, she requests that you use messaging through the Patient Portal for “official” office non-urgent requests such as refills, forms, or scheduling non-urgent appointments.  She will review these e-mails on the morning of the next business day.  In addition, texts sent after hours will be reviewed on the next business day.  For URGENT needs after hours, you will leave a voicemail for Dr. Rubin on the patient-only phone line. 

Coverage for Physician

It should be understood that Dr. Rubin is a solo physician at ITP.  That means you will get Dr. Rubin as your doctor every time you call.  But it also means that coverage for her practice must be arranged if she is unavailable for any reason (illness, vacation, continuing education, family emergency).  When time off is planned, Dr. Rubin will give at least one (1) month notice to families in the practice, and more when able.  Depending on the reason for her time off, she may still be available for text, phone, e-mail, or virtual visits, but there will be times when she is not available.  In those cases, she will arrange coverage for urgent medical needs by a local Direct Primary Care practitioner (may be pediatrics or family medicine MD).  This may not be a home visit, and there may be a nominal cost to this visit.  Use of a local urgent care is an alternative in these cases as well.  Dr. Rubin will also arrange lactation coverage in some way (breastfeeding-knowledgeable physician or an International Board-Certified Lactation Consultant) if it is urgently needed for a current member or new baby that was pre-registered prior to Dr. Rubin’s absence.  In the event Dr. Rubin needs to be away from the office without prior notice, she will make every effort to arrange similar coverage but if it cannot be made on such short notice, patients may need to utilize area urgent cares or emergency rooms. 

Refills and Forms

If you need a refill, please first check with your pharmacy to see if there are any remaining refills on your prescription.  If you do need a new prescription refill, please send the refill request to our office at least 3 days prior to when you will need the medication.  You can do this via a patient portal message.  Often the pharmacy will contact the office directly to request a refill if you have requested one from them, but do not rely on this method of refill request.  No new prescriptions will be given without a visit with the doctor for an evaluation.   

School, sports, daycare, FMLA, disability, etc. forms are all included in your membership, but they can take time to complete.  Please allow 1 week for these forms to be completed after the request is made. 

If Dr. Rubin announces that she will be absent from the office for a period of time, please check to see whether you will need any refills or forms completed while she is gone, and request these at least 1 week prior to her absence.  Even if you have not run out of your last refill yet but it will come due while she is gone, she likely can put a refill into the pharmacy to be filled when requested by you so that you will have it when you need it. 

Teen Visits and Confidentiality

In Illinois, children have the right to confidentiality at the age of 12 years old.  Dr. Rubin will request some private time with your teenager at well-checks starting at age 12.  Please consider this before a visit to determine a good place for Dr. Rubin to meet privately with your child for a few moments where you will feel comfortable.  Dr. Rubin will not do an exam on your teenager without you being within range of communication with her and your child.  Dr. Rubin may ask for some time to speak with your teen privately during a sick visit or chronic care management visit if necessary or appropriate.  Please respect your child’s right to confidentiality during this part of the visit – it is not only the law, but it is in the best interest of their mental and physical health and will allow Dr. Rubin to evaluate them thoroughly.  Virtual visits can be tricky when it comes to finding a truly private way for your child to communicate with Dr. Rubin, so please come up with a plan for this prior to the day of the visit.  There also may be some pre-visit forms that Dr. Rubin will ask your teen to complete privately prior to the visit. 

Your teen also has the right to contact Dr. Rubin and to be seen by Dr. Rubin for follow-up or acute visits of certain types (for issues related to sexuality, substance use, pregnancy, abuse, and mental health – for a more detailed description of issues that are covered by this law, please see https://www.icah.org/blog/healthcare-rights-of-youth-in-illinois.