Thank you for choosing Trophy Club Pediatrics! In order 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!

Office Policies

Confidentiality
The Clinic and Health Professionals each are required by law to maintain the privacy of your health information (“Protected Health Information” or “PHI”) and to provide you with this notice of legal duties and privacy practices with respect to your Protected Health Information. The Clinic and Health Professionals use health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. When the Clinic and Health Professionals use or disclose your “PHI”, the Clinic and Health Professionals are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure). Your health information is contained in a medical record that is the physical property of Trophy Club Pediatrics.

Patient Appointments
We see patients from 0 – 18 years of age. Once 18 years of age, patients are referred to physicians that care for adults.
Patients are seen on an appointment basis. You may call the office during normal business hours to schedule an appointment, or schedule your appointment online. Our office number is (817) 400-1572.
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 during our regular clinic hours which are from 9AM-4.59PM Monday to Thursday and 9AM to 2PM on Friday. 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 $25 no-show fee.

After Hours 

To improve access to care, our clinic offer After Hours appointments which are from 5PM-7PM Mon-Thursday. Scheduling an after hour appointment will result in an additional charge. Most insurance companies that we are contracted with pay this fee. However check with your insurance as this fee maybe applied towards your deductible or co-insurance.

Prenatal and “Meet the Doctor” Appointments
The Clinic offers prenatal visit for expectant parents. These appointments allow you to meet with the pediatrician to ask questions and get a feel for 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.

Sick Care During a Well Exam
If in the course of a patient’s well exam a non-well issue presents which needs to be addressed, the office staff will schedule a separate visit. This includes ADHD, asthma, and any other disorder. 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 payment towards a co-pay or deductible since it is not covered in a well exam.

Holidays
The office is closed on Saturday ,Sunday and all major holidays. For medical care during those times patients are encouraged to use urgent care or emergency care facilities. For Emergencies please dial 911 or go to the nearest ER.

Inclement weather

For the safety of our patients and staff, the clinic is closed during inclement weather. As a general rule we follow the NISD school closure. So if the schools are closed due to inclement weather the clinic will be closed . 

Vaccines
Trophy Club Pediatrics believes in the effectiveness of vaccines, and strongly recommends patients receive state and school mandated immunizations. Elective vaccines are also offered. Visit the CDC website for recommended vaccinations for your child.

Telephone Calls
Our office staff would be happy to answer your questions over the phone during normal business hours. Please be aware that the physician may be occupied at that moment with other patients. We will be able to take a message and relay it over as soon as possible.
Please limit after-hours calls to urgent problems. We ask that you do not call after hours to reschedule any appointments.

Prescription Refill Requests
If you need a refill on your medication, we ask that you place a request through your pharmacy, the patient portal, or call during office hours at least three days before you require the refill. The physician may need to see the patient prior to authorizing a prescription 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 bring your completed form.

USCIS - Immigration Exam

We offer the USCIS medical examination. These examinations are usually done in 2 parts. The first visit - Medical examination and PPD placement. The second visit is to read the PPD. The first visit is usually scheduled between Mondays and Wednesdays.

We charge $150 (paid cash/credit card on first day of service). This fee covers your examination and PPD only.

Your USCIS examination may require additional laboratory/radiological tests and catch up of immunization. The cost for these  will be in addition to the $150 paid for the examination and PPD.

For more information visit https://www.uscis.gov/green-card/green-card-processes-and-procedures/immigration-medical-examinations/finding-medical-doctor

For your appointment - Print your I-693 form and follow the instructions. Bring this form and your vaccine records.

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 Trophy Club Pediatrics. The steps involved depend on what records you want 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 and we will fax your information out. Our Request for Medical release form is located here

By Fax: 817-490-1920

By Mail:
Trophy Club Pediatrics
Attn: Medical Records
625 Parkview Dr Ste. 102
Trophy Club TX 76262

For Personal Use

A signed and completed authorization form is required
Medical record release to patient will result in a flat rate of $6.50 . For medical record release to third party, there will be a $25.00 fee for the first 25 pages and an additional charge of $0.15 per page copied.
All mailed records sent via certified mail carry an additional $4.00 fee.
Records may be picked up by the patient, or they may be faxed, or sent via certified mail.
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.

Payment Plans

Trophy Club Pediatrics 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.
If at any point you are unable to keep this payment agreement, and fail to notify Trophy Club Pediatrics, your account will be sent to a collection agency.


Prior Authorization to Urgent Care (UC) After the Urgent Care visit

Patient should read their insurance policies carefully with regards to Urgent Care Center. Many insurance companies require a prior authorization from your Primary Care Doctor BEFORE you go to the Urgent Care. This is completely different from going to the Emergency Room (ER) which does not need a prior authorization.
If your child is ill, please call us at 817-400-1572 to schedule an appointment. If ill health occurs after hours, your call will be forwarded to the Doctor/Nurse who will contact you same day. If you need to go to the Urgent Care, he will recommend this and will obtain the prior authorization the next business day.
If it is an Emergency, you do not need a prior authorization – please go to the ER or call 911.
TCP does not provide a prior authorization after you visit an Urgent Care.