The fact sheet below can be disseminated to parents to make it easier to provide essential information about the new screening initiative in your practice. It is also freely downloadable and customizable at www.dbpeds.org:

Customizable Information Notice to Share with Parents:

New Policy on Child Development and Behavior in Our Practice: What Parents Need to Know

A very important part of our well-child visits, is a check-up on how children are learning, behaving, and developing. This means asking you to complete one or more brief developmental-behavioral screening questionnaires at most well-child visits.

These developmental screening questionnaires help us see whether your child is at risk for problems, now or in the future, and if so, what to do next. The screening tools we use also give you a chance to talk to us about what you need to know as a parent, how you are coping as a parent, and how you are doing as a family. The questions we will ask are important because they help us to help your child become as successful in school and in life, as he or she can.

We must charge for this extra service in the amount of about (insert usual reimbursement (times the number of screens used)) for each screening questionnaire completed. You will see this on your billing sheet as procedure 96110. Most insurers pay for this service,  however, if the claim is denied by your insurer as a “non-covered” service, you will be responsible for the payment.  Please be assured we are working with the American Academy of Pediatrics to make sure this service will become fully covered by all insurers and Medicaid.

If you do receive our bill for developmental-behavioral screening after denial of the claim by your insurer, please understand how important this service is to your child’s well-being.