Frequently Asked Questions:
Do you take insurance?
No, except to cover vaccines.
Greater Cleveland Pediatrics does not accept insurance for medical services. This means that everything that we do as your primary care provider is covered by your membership fees, so no co-pays and no surprise bills! To be clear, your membership with Greater Cleveland Pediatrics is not a health insurance plan. We recommend that all families carry a separate health insurance plan.
We are considered an out-of-network provider on most health insurance plans. Your insurance company may reimburse you for out-of-network services, but this can vary widely by each insurance plan. Please make sure you speak directly with your insurance plan with questions and make sure to ask if your health savings account (HSA/FSA) can be used to pay for your membership. We are happy to provide an invoice for care as needed.
We use an external company (Vaxcare) for routine pediatric vaccines. We will collect your insurance information for this reason and your insurance will be billed directly by the company for all childhood vaccines (just as it is done by a traditional pediatric office). While most plans are included, If vaxcare does not accept your insurance plan, we will work with you to determine an alternative solution.
What is Direct Primary Care?
Direct Primary Care is a model of delivering medical care that builds upon the traditional doctor-patient model. It prioritizes the doctor-patient relationship without the unnecessary complication of insurance companies. This model allows doctors and patients to be directly in charge of their health and do what is best for each individual patient. It is personalized, high-quality care paid for with a monthly membership fee. So many families are realizing the benefits of this approach to care: the Direct Primary Care model has been growing quickly across the United States. We are excited to be the first pediatric Direct Primary Care office in Northeast Ohio.
Why would I pay a membership fee when I already pay for health insurance?
Think about it: truly everything you ever wanted in a pediatrician for less than $6 per day. It’s the best $6 you can spend for your children.
Having health insurance does not mean you are receiving high quality health care. In contrast to insurance-based medical care, this model is designed with the patient as the top priority. Our unique approach puts the patient’s needs first: high-quality, personalized care at a time that is convenient for families.
Our focus is on the quality of patient care, not the quantity of visits packed into each day. And even more, you never pay an insurance co-pay for your visits. All sick and well visits at the office are included —whether you come once a month or 20 times a month!
And don’t forget, because we take care of so many fewer patients, your child can be seen that same day without any waiting time at the office. Imagine all of the time you won’t need to take off from work!
If your child gets sick at 9pm, you call us then! Gone are the days of unnecessary visits to an urgent care, emergency room, or unhelpful calls with a nursing triage system who does not know anything about your child. You will have direct access to your pediatricians when you need us most, 24/7. We believe that this is the way medical care is supposed to be delivered.
How do I pay for my membership?
Membership fees are charged to you bank account, credit or debit card automatically once per month. You can also choose to pay the full annual amount each year (at a discounted rate). A one-time enrollment fee of $100 per family is due upon joining.
What is NOT included in my membership?
It is important that all patients still carry health insurance. While our services are extensive and include all typical primary care services and visits in your membership fee, some services are not covered:
Visits with any physician or sub-specialist outside of Greater Cleveland Pediatrics. This also includes any visits to an urgent care, emergency room, or hospitalization.
Any procedures, labs, or prescriptions obtained outside of Greater Cleveland Pediatrics. This will be billed to your insurance as is customary.
Vaccines. As noted above, we will collect your insurance for verification. It will then be billed directly by the vaccine company (Vaxcare).
What if I can’t afford the membership fee?
We have reserved a limited number of memberships at a reduced rate. Generally, these are for medically complex children, children of active service members, community workers, religious leaders, and foster parents. We also have special rates for current medical/dental residents and fellows as well as students with families. Please contact us to discuss if you would quality for one of our reduced rate memberships.
Do you offer virtual visits?
Absolutely! One of the tenants of Greater Cleveland Pediatrics is to provide convenient care for our families. Especially for patients who we know and trust, so many things can be done virtually! And, of course, this is included as one of the perks of membership! Certainly, we will have our patients come into the office whenever we are concerned and want to see you in person, but sometimes this just isn’t necessary! And, the ability to easily do visits virtually is so helpful when our families are traveling out of town!
Do you offer house calls?
Absolutely! We include house calls for all newborns for the first two months of life as part of your membership. We are happy to continue to offer house calls for an additional fee for any older children, or at the discretion of the doctor—sometimes the very last thing we want you to have to do is bring your sick child to the office!
What precautions are you taking with the COVID-19 pandemic?
At Greater Cleveland Pediatrics, we are taking the COVID-19 pandemic very seriously. Your family’s safety is our top priority. It is almost like our practice model was designed for this! Our small size allows us to see fewer patients every day, which means that fewer patients are coming in and out of the office. Most of the time, your family is likely to be the only one at the office! We will see patients at their home, in their car, or in the special room which has been designed as our sick room and cleaned from top to bottom between every patient. If indicated, we can coordinate COVID-19 testing for your child.
What is your policy for vaccines?
We believe in vaccines. It’s actually evidence-based science, not a belief! Vaccines are safe and effective and we strongly recommend that all children receive all routine vaccines according to the CDC guidelines. We also understand that some families may have concerns regarding vaccines. We will work with your family and discuss your concerns.
Will you see my baby in the hospital?
Of course. If your baby is born at Cleveland Clinic Hillcrest or University Hospitals MacDonald Women’s Hospital, Drs. Keili and Allie will care for your baby during the newborn hospital stay. If you child is born at a different hospital, we will be certain to be in touch with the doctor who is caring for your baby.
What happens if my child is admitted to the hospital?
While we do not directly take care of patients who are admitted to the hospital, we will be actively involved in your child’s care from start to finish. We have relationships with the doctors (called “hospitalists”) who take care of hospitalized children at all of the local children’s hospitals in Cleveland and will work closely with this team of doctors during your child’s stay. After discharge, we will see your child and ensure continuity of care. Drs. Keili and Allie both have hospital privileges at University Hospitals Rainbow Babies and Children and the Cleveland Clinic Hillcrest Hospital.
