Policies

Dear Patient,

You are being provided this letter of acknowledgement because you have requested that your doctor visit today be coded as “self-pay” and that you receive a “self-pay discount.” A self-pay discount is offered to patients who elect to pay for the service in full on the date of service and who will not be submitting the claim to an insurance carrier. You have requested that this service be coded as self-pay because (initial one):

  ___   You have no health insurance.

  ___   You have health insurance but you do not want your insurance billed and instead want to pay out of pocket.

  ___   Other (please explain):       Dr. Gravitt is not currently a network provider

We want you to know what to expect so that you can make an informed decision.    In order to accomplish this, by signing below you agree to the following:

• All fees for the self-pay service must be paid on the date of service.
• The self-pay amount covers only the professional services provided by your physician. You are financially responsible for all ancillary services, for example laboratory, x-ray or other services not performed by Little Legends Pediatrics, LLC.
• If you have insurance or other types of coverage, services received today that are included in the “self-pay” discount will not likely be reimbursed by your carrier, or applied to your deductible. You may want to discuss this with your insurance carrier before agreeing to the self-pay discount.

HIPAA Notice of Privacy

HIPAA Consent

Patient Guide to HIPAA

Messaging Privacy Policy

Messaging Terms & Conditions

As medical professionals, we feel very strongly that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults. We are making you aware of these facts not to scare you or coerce you, but to emphasize the importance of vaccinating your child. We are more than willing to discuss any questions you may have about vaccines, but do strongly advise all new patients to our practice to adhere to the vaccination schedule endorsed by the American Academy of Pediatrics (AAP)

• We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives.
• We firmly believe in the safety of our vaccines.
• We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). 
• We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities. 
• We firmly believe that thimerosal, a preservative that has been in vaccines for decades and may remain in some vaccines for older children and adults, does not cause autism or other developmental disabilities.
• We firmly believe that vaccinating children and young adults may be the single most important health promoting intervention we perform as health care providers, and that you can support as parents/caregivers.

The recommended vaccines and the schedule of administration are the results of many decades of scientific study and data-gathering on hundreds of millions of children by thousands of the brightest scientists and physicians around the world.

The vaccine campaign is truly a victim of its own success. It is precisely because vaccines are so effective at preventing illness that we are even discussing whether or not they should be given. Because of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox, or known a friend or family member whose child died of one of these diseases. Such success can make us complacent or even lazy about vaccinating. But such an attitude, if it becomes widespread, can only lead to tragic results.

Over the past several years, many people in Europe have chosen not to vaccinate their children with the MMR (measles, mumps, rubella) vaccine after publication of an unfounded suspicion (later retracted) that the vaccine caused autism. As a result of under-immunization, there have been small outbreaks of measles and several deaths from complications of measles in Europe over the past several years. The United States experienced increasing numbers of measles cases the past several years, with 1282 cases from 31 states reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD) in 2019. These numbers are alarming given that measles elimination was documented in the U.S. in 2000.

Furthermore, we firmly believe that by not vaccinating your child, you are taking advantage of thousands of others who do vaccinate their children, which decreases the likelihood that a child will contract one of these diseases. We feel such an attitude to be self-centered and naive. Even delaying or “breaking up the vaccines” to give one or two at a time over additional visits goes against expert recommendations, is not supported by any legitimate scientific data, can lead to unnecessary delays and errors, and can put your child, other children, and adults at risk for serious illness (or even death). It is therefore against our medical advice as professionals at Little Legends Pediatrics.

While splitting or refusing vaccines will not exclude your child from being seen by our practice, we will not sign any school/camp/daycare/etc. forms that put them in contact with others who may be susceptible to vaccine preventable diseases if they are missing any required vaccinations.  Release of liability forms will be mandatory for any declined vaccines.