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Performance Pediatrics Patient Newsletter
In This Issue
Linda's Retirement
Policy Updates
Forms for Camp
Vaccination Corner
Peanut Allergies
Paying for Healthcare
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Linda's Retirement
Long-time receptionist Linda Allen is retiring and we are going to miss her! Please join us in thanking Linda for her years of service and in wishing her a happy retirement!

We are currently recruiting for a new part-time receptionists via Monster.com. Follow the link to learn more.
Policy Updates
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We have updated a number of our policies and added a few new ones for you to review. Please follow these links to read our new and updated policies on:

Requests for Notes for School and Work

 

Patients'/Parents' Rights & Responsibilities for Care Coordination

 

Referral Request Policy 

Forms for Camp

As the snow starts to melt, our thoughts turn to plans for summer.

 

Most camps require an updated health form that shows vaccines given and the date of your child's last well exam. In our experience, camps will accept our standard medical form in lieu of their form. Parents are able to access our standard school/camp form via the Performance Pediatrics Secure Patient Portal. On the portal, select the child's name on the home page, go to the patient information tab and follow the forms link.

 

A special note to parents of adopted children: Dr. McAllister and his family highly recommend Camp Clio in Lyme, Connecticut. Camp Clio provides a unique opportunity for adopted children in a fun, old-fashioned camp setting. Visit http://campclio.org/ to learn more. 


Spring 2015 
Vaccination Corner
Parents Who Refuse to Vaccinate 

shot_preparation.jpgDr. McAllister writes a monthly blog for Physicians Practice Magazine. The blog is free to read, but you do have to be a registered member (also free) of the website to access it.

This is taken from  his January post:

Online and in several parents' groups, our practice has been deemed a "vaccine friendly" practice. The "vaccine friendly" label has been used to designate a physician who will not discharge a family for refusing to vaccinate their children.

We're not sure how we feel about being designated as such a practice. On the one hand, we agree to follow the American Academy of Pediatrics (AAP) recommendation that pediatricians continue to treat patients who refuse vaccination. And yet, by complying with this request, are we not signaling to patients that we agree with their vaccine refusal? This is our struggle.

Just this month, the amazing team at Freakonomics took an in-depth look at why people don't get flu vaccination. Their data led them to conclude that scientific evidence is not effective in persuading non-vaccinators, but scare tactics are.

Yikes! Even if we believe this (and we kinda do), who is responsible for scaring patients into submission? It is certainly not the primary-care provider who gives patients a safe space to talk about sensitive issues including sexual and mental health.

If you have questions about vaccines, please read our vaccine policy, vaccine billing policy and refusal to vaccinate release form. At your child's appointment Dr. McAllister or Nurse Practitioner Jen will review the policies and form with you.
Peanut Allergies
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New Research Shows that Peanuts Should be Introduced to Infants  

 

New research shows that peanuts should be introduced to infants at age 4-6 months when other solid foods are introduced.

 

Peanut allergies are a common problem and becoming more common over time. The prevalence of peanut allergies has more than quadrupled in the past 13 years, growing from 0.4% in 1997 to 1.4% in 2008 to more than 2% in 2010. Peanut allergies can be very severe and are the leading cause of anaphylaxis and death related to food allergy in the United States. It is not clear why peanut allergies are increasing but some interesting research is being done to find ways to reverse this trend.

 

A recently published study in the New England Journal of Medicine showed that allowing children at high risk for developing peanut allergies to consume peanuts from infancy through age 5 decreased the risk of developing an allergy. Some 640 infants (age range, 4-11 months) with severe eczema or egg allergy were divided into two groups. The first group was given peanuts (2 g peanut protein 3 times/week) and the second group avoided peanuts until age 5. The prevalence of peanut allergy at age 5 was significantly lower in the peanut consumption group than in the avoidance group (1.9% vs. 13.7%).  

 

Although more research has to be done to find the best way to prevent peanut allergies from developing, the authors of that study recommend that peanuts be introduced to infants at age 4-6 months when other solid foods are introduced. However any infant between 4 months and 8 months of age believed to be at risk for peanut allergy (bad eczema or other documented food allergies) should undergo skin-prick testing for peanut. If the test results are negative, the child should be started on a diet that includes 2 g of peanut protein three times a week for at least 3 years. If the results of the skin prick testing are mildly positive the child should undergo a food challenge in which peanut is administered and the child's response observed by a physician who has experience performing a food challenge. At Performance Pediatrics we agree with the recommendations and think most infants should be exposed to peanut products in their diet.

 

If you feel your child is at high risk for developing an allergy please talk to us before introducing peanuts.

Paying for Healthcare
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Paying for healthcare can be overwhelming. Here is some basic information on why we charge what we do and how to get help paying your medical bills.

Correct Coding 
Charges for our services at Performance Pediatrics is highly regulated by the Federal and State government. We subscribe to the AAP Pediatrics Coding Newsletter and follow all National Correct Coding Initiative (NCCI) rules. When we submit codes for services to your insurance plan, your insurer decides, based on the specifics of your plan, what they will cover and what they will pass onto you, the patient. The insurance company makes us, Performance Pediatrics, their collection agency. However, we do not decide what to charge you. By law, because we see MassHealth patients, we must charge all patients the same, including codes for behavioral health screens and codes for services after 5 pm on weekdays and on Saturdays. Most plans do not pass these charges onto the patient, but some can, and do. When we mail you a bill, it is because your insurance plan determined what you owe. Questions about bills must be directed to the insurance plan.

Who Qualifies for Financial Help
Many families in our community are shocked when they learn that they qualify for assistance in the purchase of health insurance. According to the Federal Guidelines, a family of 5 can earn up to $111,640/year and still obtain free or low-cost insurance for their children.

How to Apply for MassHealth
More than 30% of our families have MassHealth as a secondary plan (we do not accept it as a primary plan for new patients). Unfortunately, the paperwork required is not easy to understand. Not only is there a lot of initial paperwork, but even once you obtain the policy you must continue to complete paperwork as required by MassHealth. Still, if you qualify, it can significantly reduce your out-of-pocket costs for healthcare. We recommend contacting Health Care for All, a wonderful not-for-profit agency that can answer your questions and help you to complete paperwork. Please note that we are NOT in network with all MassHealth plans. When signing up for a new plan, always check to make sure that Dr. McAllister and/or Performance Pediatrics is in your new network if you want to stay with our practice.

Be well,


Terence R. McAllister, MD FAAP
Medical Director
&
Jennifer L. Byrne, CPNP
Medical Home Care Coordinator

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