CIRCUMCISION PAYMENT POLICY
 
  One of the first decisions that parents of newborn baby boys are asked to make concerns whether or not they would like their son to be circumcised.  Circumcision involves the surgical removal of a portion of the foreskin of the male penis.  When circumcision is desired, it is usually done in the newborn period (within the first two weeks of birth), with the infant awake, and often with the aid of a local anesthetic. Social and medical rationale, both for and against routine newborn circumcision, have changed over time, and cultural traditions vary greatly throughout the world today on this matter.  Today, while some social and/or religious traditions may favor circumcision, there is not sufficient medical evidence that it is necessary.  The American Academy of Pediatrics (AAP) has made the following statement regarding circumcisions, based on the available medical literature: Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.  In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should deteremine what is in the best interest of the child.  To make an informed choice, parents of all male infants should be given accurate and unbiased information and provided the opportunity to discuss this decision.  If a decision for circumcision is made, procedural analgesia should be provided.  It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making  this decision.  Analgesia is safe and effective in reducing the procedural pain associated with circumcision; therefore, if a decision for circumcision is made, procedural analgesia should be provided.  If circumcision is performed in the newborn period, it should only be done on infants who are stable and healthy."  Pediatrics, Volume 103, Number 3, March 1999, pp. 686-693 Based on this statement, and in an effort to cut their costs, some insurers, including North Carolina Medicaid, are no longer covering routine newborn circumcisions.  If your child's insurance carrier is among this group that considers circumcisions to be a non-covered, or elective service, you will be financially responsible for paying for the procedure if you opt to have your son circumcised.  Mountain Area Pediatric Associates, P.A.'s current charge for this procedure is $300.00, and is payable prior to circumcision being done. If you choose to have your son circumcised, please sign this form and the circumcision consent form, and call our office at 254-5616 ext. 1 to arrange a payment plan (to be paid in full prior to circumcision being done).  Thank you for your consideration in this matter. I, ________________________________ have read the above information regarding circumcision and agree to its terms and conditions. ______________________________________     __________________________ Signature                                                                    Date   ______________________________________     __________________________ Witness Signature                                                       Date