UH Rainbow Children’s Medical Group Services

To help provide timely service to our patients, we prefer to schedule all visits. Please give the office a call directly.

If you are more than 10 minutes late, we will need to confirm your appointment with the provider.

We kindly ask that you allow 3 – 5 business days for form completion. Forms must be dropped off at the front desk during normal business hours or faxed anytime. Your portion of the form should be filled out completely, including your child’s name and date of birth. If the form requires a doctor’s signature, the child must have had a physical within the last year or it cannot be signed. Please remember to schedule your child’s physical yearly.

Forms for School, Sports or Camp

1. Forms must be completely filled in by the parent, including exact name of medications on the bottle and form, ie: pill, liquid, and dosage.
2. If your child is seen by a specialist, please have the specialist sign the forms.

• Patient Registration Form
• Pediatric Health History
• Parent/Guardian Consent to Treat Minors
• UH General Consent Form
• Parent/Guardian Personal Health Record Account Request Form
• Authorization for Release of Medical Information
• Ohio High School Athletic Association Pre-Participation Physical Exam
• ADHD Vanderbilt Parent Form
• ADHD Vanderbilt Teacher Assessment Form

Refill requests must be made 1 week in advance of the last dose. Please allow 3-5 business days for processing.

Med check appointments must be made and attended every three months or there will be no refills prescribed. Refill requests must be made 1 week in advance of the last dose. Please allow 3-5 business days for processing.

IDs and insurance cards must be presented and verified at the front desk upon check-in at each visit. If insurance remains unverified two weeks after the visit, the visit will be billed as self-pay, with the exception of newborns.

Under the law, patients who do not have insurance, choose not to use insurance, or are receiving care from an out-of-network provider and do not have out-of-network health insurance benefits have the right to receive an estimated bill that outlines their out-of-pocket costs for medical items and services before proceeding with medical care. Payment will be mandatory at the time of service.

In advance of scheduling a new patient, at minimum, an immunization record must be received by the office. Please arrive 20 minutes early to assist with registration. If you miss your first appointment with the practice, we will be unable to continue service.

A missed appointment (with no phone call 1 hour prior to scheduled appointment time) is considered a “No-Show”. Our policy is as follows:

• 1st No-Show: a call to the family to try and reschedule.
• 2nd No-Show: may result in a $25.00 charge to the family. (Insurance will not cover this fee.)
• 3rd No-Show: the patient and/or family will be discharged from the practice.

If a parent wishes to send their minor child to the office unaccompanied, the office must have a consent form filled out and scanned into the patient’s chart authorizing the minor to transport themselves to appointments. NOTE: This does not apply to new patients. Until the office has an ID, insurance card and signed consent on file, the minor will be unable to arrive for appointments unaccompanied.

If vaccines are to be given and there is no parent/guardian present, two options exist. The parent must be available by phone to provide verbal consent OR the parent must send a note with the minor authorizing vaccines.

As a parent or legal guardian, you can manage your child’s online health information. Visit the MyChart for MyFamily section of our FAQs to learn more.

Our phone lines are open Monday – Friday 8:15 a.m. – 5 p.m. Our staff will take a message, and a nurse or doctor will return your call, usually by day’s end.

You can ask your provider questions via the MyChart app. Message responses may take up to two business days. If this is an emergency, please call 9-1-1.
Login or register for MyChart.

Nurses staff our after hours calls, triaging and advising as needed. One of our physicians is always on call to aid them if needed. Please reserve routine calls for office hours.

If an emergency should arise, please call 911. Emergencies are considered to be those conditions that are life-threatening: loss of consciousness, severe bleeding, seizure, etc. In the case of minor emergencies (lacerations, cuts, mild fractures, sprains), please call our office first for instructions.

Appointments are available upon request.

We make every effort to schedule appointments for ill children on the day that you call us. Please call our office ahead of time so that we can minimize the time that you will spend waiting. If you have a medical emergency during office hours, we will do our best to see your child immediately or refer you to the appropriate facility.

To keep your children healthy, it is important to bring them in for regular checkups. We recommend that you call our office at least 2 weeks in advance so you may choose the date that best fits your needs.

UH MyChart allows us to e-prescribe any prescriptions at your appointment within seconds. This will allow us to keep better track of all medications you are currently or have been taking, even if prescribed by another office. For prescription refills please try to give as much advance notice as possible; feel free to leave a message for the nurse, we ask that for most refills your child's physical is up-to-date.

Medications that are more closely regulated by the FDA have different requirements for prescribers. We are required by law to see your child regularly to monitor medication use and usefulness.

University Hospitals no longer accepts cash or check as in-person payment for services. You can pay by card (credit, debit, HSA, FSA, etc.), Apple Pay or Google Pay. You can also use UH MyChart to pay your bill online or before your appointment during eCheck-in. We accept checks for payment by mail.

You can now quickly and easily pay your provider bill online using our convenient online bill pay tool.

We accept most insurance carriers. Please have your card with you upon scheduling an appointment and at the time of your visit. If we file your claim, you are responsible for only the co-pay at the time of the visit. If we are not a participating provider for your insurance, if you are not insured, or we do not file with your insurance company, you may be responsible for the entire charge at the time of service.

It is the responsibility of the insurance policy holder to understand their coverage as well as select providers who are in-network for their particular plan.

Per the UH General Consent for Treatment, parents/legal guardians hereby agree to pay any and all UH or affiliated provider fees that exceed or that are not covered by insurance coverage. A copy of the UH General Consent for Treatment form can be provided upon request.