Tom Benton, M.D. Benton Pediatric Group, Inc.











 

Patient Services and Information

New Patients
Appointments
   *Emergencies
   *Sick Visits
   *Health Maintenance/Routine Visits
   *Academic and Behavior Problems
   *Sutures, Wart Removals and Nail removal
   *Circumcisions
   *Pelvic Exams
   *Saturdays
   *Appointment Confirmation

Insurance

Printable Forms
   *Patient Information
   *Insurance Reimbursement
   *Insurance Assignments and Authorization to Release
   *Information
   *HIPPA
   *Newborn History (for Newborns only)
   *Patient History
   *Family History
   *Other Printable Forms

Perscription Refill
On Going ADD/ADHD Management
Referral to a Specialist

 

NEW PATIENTS
If you have just had your first child, are new to the area, or just looking to change pediatricians, call our office to schedule a consultation visit. This appointment allows you to meet Dr. Benton and the Benton Pediatrics team. There is no charge for this “meet the friendliest pediatrician's office in town visit.”

Please bring the following to your first visit:

•  Recent insurance card
•  Medical records (especially shot record) from your previous Primary Care Physician (PCP).
•  Payment/Co-Payment

 

 

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APPOINTMENTS

**WE SEE PATIENTS BY APPOINTMENT ONLY**

WE ARE OPEN
8AM to 5PM Monday through Friday
and Saturday from 8:30AM to Noon

*** Please call mid-morning or early afternoon to schedule a check up or other routine/non-urgent visits.***

Emergencies:
Let us know “It's an emergency!” and your call will be taken immediately.

Sick Visits:
If your child is ill, call before noon and we will see you that day.

Health Maintenance/Routine Visits:
We recommend “check-ups” at age 2 weeks, 2, 4, 6, 9, 12, 15, and 18 months, and then annually starting at 2 years of age. Be sure to schedule these appointments at least a month in advance. 

Academic and Behavior Problems:
We offer evaluation and treatment plans for academic and behavior problems, including ADHD. Please bring the following information when requesting an evaluation for academic problems:

•  Results of standardized tests (e.g. FCAT)
•  School grades for the current year and last year
•  Results of any psycho educational testing that has been done
•  Vanderbilt surveys filled out by teachers, parents, and close family members (For printable surveys click here)

Sutures, Wart Removals and Nail removal:
We perform simple laceration repairs, wart removals and nail removals

Circumcisions:
Circumcisions are offered to male infants less than thirty days old. This can be performed in the hospital shortly after birth or in the office.

Pelvic exams:
Both Dr. Benton and Elizma Mercier , PA -C perform pelvic exams. Your preference will be honored in regards to whom you wish to do this exam.

Saturdays:
We open Saturday mornings to see ill patients.
We do not have staffing available to return routine phone calls on Saturdays.

Please Confirm Your Appointment:
Prescheduled appointments must be confirmed.
If appointments are not honored or are cancelled with insufficient notice, the treatment of ill children is unnecessarily delayed. To accommodate patients in a timely manner, it is important that appointments be kept.

Unconfirmed appointments may be cancelled:
We now have a voice mail confirmation line available for use after hours. Call the office, 352-376-4542, day or night, for instructions.
Or click here to confirm your appointment.

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INSURANCE

Be sure to always update your insurance with us. If you received a new card, even if your policy has not changed, please bring it to your next visit so we can get a copy for our files.

We accept most major insurance companies including BC/BS, Health Options, Blue Options, AvMed, Cigna, VISTA and United Healthcare. Understanding your own health insurance coverage is very important. You are responsible for knowing what your coverage allows.

Payments/Co-payments are due at the time of your visit.

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PRINTABLE FORMS
The following forms need to filled out for each patient and given to the office at the first visit:

Click on form to be printed. Adobe Reader is needed. Adobe Reader is a free download. If you do not have it click button to download.

Patient Information
Insurance Reimbursement
Insurance Assignments and Authorization to Release Information
HIPPA
Newborn History (for Newborns only)
Patient History
Family History

Other Printable Forms:

ADD/ADHD
Vanderbilt (new & follow-up)
   *Vanderbilt--Parent Follow Up
   *Vanderbilt--Teacher Follow Up
   *Vanderbilt--Parent New
   *Vanderbilt--Teacher New
Consent to Obtain Medical Treatment
Medical Release

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PRESCRIPTION REFILLS

  • Refills of medication must be requested a minimum of one week prior to patients taking last dose of medication.

ON GOING ADD/ADHD MANAGEMENT

  • Appointments with a practitioner are required every three months
  • Refills will not be given unless the patient's next recheck appointment has already been scheduled.
  • Failure to keep scheduled recheck appointments, whether the appointments are rescheduled or missed, may result in a lapse in dosing or discontinuation of medication refills.
  • The following paperwork is needed at the recheck appointment:
    **Results of standardized testing done since the patient's last ADD/ADHD visit
    **School grades for the same time period
    **Results of any psycho-educational testing done since the last visit
    **ADHD Vanderbilt Surveys out by teachers & close family members

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REFERRAL TO A SPECIALIST

We are committed to obtaining referrals to specialist in a timely fashion. We rely on you, our families, and patients, to help with this process. When a need arises for an emergency referral, we drop everything until the referral is made. Urgent referrals are handled in a few days and “routine” referrals are handled within a week.

So, how can you help us with this? Several ways. First, don't arrive for an appointment with a specialist without a referral if your insurance company requires you to get one. Second, if we don't contact you when we say we will, let us know – we're human and rely on you to tell us when we haven't met our stated timeline for completion of a referral. Third, ask the specialist to send us a report communicating what was done and what the plan is.

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