66 Mount Lucas Road, Princeton, NJ 08540-2733, USA
tel 609-924-4892, fax 609-921-9380
Mark B. Levin, M.D., F.A.A.P.
John M. Cotton, M.D., F.A.A.P.
Timothy J. Patrick-Miller, M.D., F.A.A.P.
Louis J. Tesoro, M.D., F.A.A.P.
Helen M. Rose, M.D., F.A.A.P.
MANAGED CARE POLICY STATEMENT
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Dr. Cotton: cotton@pedgroup.com
Dr. Patrick-Miller: pmiller@pedgroup.com
Dr. Tesoro: tesoro@pedgroup.com
Dr. Rose: rose@pedgroup.com
Billing: billing@pedgroup.com
Information: information@pedgroup.com
We are happy to answer any general questions about medical topics and about ouor practice. We can answer specific questions only regarding patients who are currently enrolled in our practice.
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Cost versus Quality
Many of our patients have asked if we will be joining a prepaid or managed care health insurance program. We realize that, for many families, health insurance premiums are very costly, especially for point-of-service or traditional fee-for-service plans. We have researched managed care plans regularly since their inception and continue to conclude that they are not in the best interest of medical care. Indeed, there are increasing instances in the lay and the medical press of managed care plans shirking responsibility for adverse outcomnes because of denied coverage. Nevertheless, premiums for managed care plans are approaching those for fee-for-service coverage.
Our practice, established in 1955, has always delivered high quality care 24 hours per day, 7 days per week at a reasonable price. When families have brought financial problems to our attention, we have always been willing to make special considerations regarding payment. We can perform many procedures in our office, using hospitalization only as a last resort, thereby sparing families and children much anxiety and expense. We have designed our office to enable to treat your youngsters as we would our own children. With in-house laboratory and x-ray facilities, for example, we can perform many tests rapidly and at lower cost than a commercial laboratory. Having this capability also allows us to make decisions without needless delay. Managed care plans all require that laboratory tests be performed at a laboratory contracted for by the plan, thereby introducing unnecessary delay.
For conditions that require additional expertise, we have developed a superior network of consultants. Under our system, we can select the best available specialist for the child's needs, rather than being obliged to settle for someone just because they are "in-network." The same applies to the rare child who must be hospitalized. We manage the care of our patients in the hospital. Except under circumstances requiring specialist care, we do not transfer the care of our patients to other doctors. If a child needs more care than can be offered at the University Medical Center at Princeton, we transfer them to the best facility within a safe traveling distance. Under our system, we are not constrained from referring a child to a specialist or obtaining a laboratory test in situations we believe that call for those interventions. Similarly, we are able to prescribe medications that we feel are best for the specific condition rather than being constrained by an insurance plan formulary list.
We believe that high quality care is worth the marginal increase in cost. We also believe that cost should be a consequence of medical care administered, not a consequence of insurance companies wanting to increase revenues for their stockholders.
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