logo for Ivy Children's Clinic

350 Westpark Way, Suite 123, Euless, TX 76040 | 817.267.3065

New Patients

We want to thank you for choosing Ivy Children’s Clinic. In an effort to help familiarize you with our office policies and procedures, we are listing them below. If you have questions about any of those, we encourage you to contact us. We look forward to seeing you in the office soon.

Accepted Insurance

We accept many insurance carriers. For your convenience, we have listed our most popular insurance companies. This is not an inclusive list of all the plans with which we participate. Please call our office if you have any questions.


Aetna POS/POS II/EPO/PPO
BCBS PPO/POS/HMO
BCBS Premier HMO
BCBS Blue Advantage HMO
Cigna
Coventry
First Health
Healthsmart
Humana PPO/POS
Meritain Health
PHCS/Multiplan policies
Scott & White Health Plan
United Healthcare
United Health One
UMR
Web-TPA

Office Policies

Confidentiality

We understand your medical information is personal, and we are committed to protecting this information. We will not disclose information regarding your condition to anyone without your written, signed consent. We will only use your health information for treatment, to obtain payment for services provided, or to provide employees with information about you relevant to your care. We will disclose information in special circumstances, such as when required by law, to prevent a serious threat to your health and safety.


Patient Appointments

We see patients from 0 – 18 years of age. Once 19 years of age, patients are referred to physicians that care for adults.


Patients are seen on an appointment-only basis. You may call the office during normal business hours to schedule an appointment or schedule your appointment online. Our office number is (817) 267-3065.


Please be aware that patients who arrive more than 10 minutes late for their appointments may be asked to reschedule.


If you have a scheduled appointment time and need to reschedule or cancel, please notify our office at least 24 hours prior to your appointment. We will gladly reschedule a more convenient appointment time for you. If you do not show up for your appointment, you will be charged a $30 no-show fee.


Prenatal and “Meet the Doctor” Appointments

The physician is available around her lunch hour to meet with parents or parents-to-be. These appointments allow you to meet with Dr. Nnamani, ask questions, tour the office and get a feel of our practice. Prenatal appointments also provide expectant parents with an opportunity to ask questions about what to expect with regard to their newborn. There is no fee for both of these appointment types.


Please complete the Prenatal Visit Form and bring it to the office.


Holidays

The office is closed on the weekends, and for all major holidays. For medical care during those times, patients are to use urgent care or emergency care facilities.


Vaccines

Ivy Children’s Clinic believes in the effectiveness of vaccines and strongly recommends patients receive state and school-mandated immunizations. Elective vaccines are also offered. Click here to view our immunization schedule or visit the CDC website for recommended vaccinations for your child(ren).


For families who will be refusing/declining vaccines for their children, Ivy Children’s Clinic kindly refers these families to the Tarrant County Medical Society (PH#817-732-2825) to search for other medical practices in agreement with an anti-vaccine medical philosophy.


Telephone Calls

We are available to answer your questions over the phone during normal business hours. Many of the calls are reviewed by the physician.


Please limit after-hours calls to urgent problems. We ask that you do not call after hours to discuss routine problems such as sleep/appetite issues, prescription refills, medication dosages, and other non-urgent issues.


There is a $30 charge for each non-urgent after-hours phone call.


Prescription Refill Requests

If you need a refill on your medication, we ask that you place a request through your pharmacy or the patient portal, or call during office hours at least three days before you require the refill. We do not refill medication after business hours or on the weekends.


School/Camp/Office Forms

All forms will be completed within 3 business days. If you are coming in for a school physical, please download the school physical form and complete the top portion.


Medical Records Release

To maintain patient confidentiality and assure compliance with federal and state privacy laws, health information may not be released without a patient’s written authorization (except as permitted by law). The information below describes the process of requesting medical records that you may have at Ivy Children’s Clinic. The steps involved depend on what records you want to be provided and/or to whom you want your records provided. Signed authorization forms must be submitted in person, by fax, or via mail.


In Person:

Drop off the signed form at the front office of Ivy Children’s Clinic. Download an Authorization for Medical Records Release here.


By Fax:

817-545-9097


By Mail:

Ivy Children’s Clinic
Attn: Medical Records
350 Westpark Way, Suite #123
Euless, TX 76040


For Personal Use

A signed and completed authorization form is required. Download an Authorization for Medical Records Release here.


There will be a $25.00 fee for the first 25 pages and an additional charge of $0.15 per page copied.


Records may be picked up by the patient, or they may be faxed, or sent via certified mail. All mailed records are sent via certified mail and carry an additional $15.00 fee.


After we receive your completed authorization form, you will be notified of the total cost to prepare a copy of your records.


Your request will be processed upon receipt of payment, with a timeline of up to 15 calendar days to process the request.


For an Outside Provider or Facility

A signed and completed authorization form is required, and no fees will be charged to process requests. Up to 15 calendar days will be required to process requests. Download an Authorization for Medical Records Release here.


Sick Care During a Well Exam

If in the course of a patient’s well exam a separate, non-well issue presents which needs to be addressed, it may be addressed during the current visit or at a subsequent visit.


If addressed at the time of the current well exam, an additional E&M code (evaluation and management) will be added to the visit.


Your insurance company may require a second co-pay or a deductible may apply for the additional service or procedure.


Payment Plans

Ivy Children’s Clinic policy is that any charges such as co-pays, deductibles, or non-covered services are due at the time of service. However, we do offer a limited payment plan for those patients who need some flexibility, with the following criteria:


You will be required to provide us with a credit or debit card number to automatically process your payment on specified dates. This can be done by completing the Payment Plan Consent Form.


The balance must be paid in full within six months of the date of service (unless otherwise specified), or six months from the date that we received payment from your insurance company (if applicable).



Regular statements will not be mailed for this balance.


No future charges may be added to this payment plan, as it is not intended to be a revolving charge account.

If at any point you are unable to keep this payment agreement and fail to notify Ivy Children’s Clinic, your account will be sent to a collection agency.

Patient Registration Forms

Please download and complete the Patient Registration Forms and bring them with you to your first visit, along with your photo ID and insurance card.


Forms

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