All posts by Nicholas Hannah

Tips to Stay Healthy During Flu Season

Tips to Stay Healthy During Flu Season

We are seeing quite a few patients in our office the last few weeks for a wide variety of illnesses. The flu has been running around the community right now as we have had several positive tests in our office. The following tips can help you and your family stay safe and healthy throughout the flu season.

  1. Talk to your doctor. Make sure you stay in touch with your doctor if you are at higher risk for flu complications.
  1. Wash your hands frequently. One of the best ways to stay healthy is to wash your hands often. Flu viruses are spread by bodily fluid from those who are infected. They can spread the virus by sneezing, blowing their nose, or wipe away other fluids from their nose or eyes. Of course, encourage your children to keep their hands out of their mouths, avoid rubbing their eyes, and to wash their hands thoroughly several times a day, especially before a meal.
  1. Eat a healthy diet. As with staying healthy, eating a quality meal three times a day can help in supporting a immune system. Foods rich in vitamin E (sunflower seeds, almonds and peanuts) and vitamin C (orange juice, broccoli, and green peppers) can assist. Finally, make an effort to reduce the intake of sugars (soda and candy).
  1. Get a quality nights rest. Sleep can help boost your child’s immune system.
  1. Stay hydrated. Increasing your water intake can help you stay healthy and lessen the chance of coming down with the flu. In the case you do come down with a virus, drinking extra fluids can help lower dehydration caused by fever, loosens mucus, and keeps your kiddo’s throat moist.
  1. Exercise regularly. Exercising can certainly help by lowering stress, but research also shows that it can assist in stimulating your immune system.
  1. See your doctor if you develop symptoms. If your child’s symptoms get worse after three days, especially if the fever comes and goes, give us a call. We offer same day sick appointments, so make sure you call at 9 a.m. when our phone lines open to schedule an appointment. The flu virus can leave your body vulnerable, so we want to make sure your child is not at any further risk.

Marketplace Update

Marketplace Update

By: Nicholas J. Hannah

December 30, 2014

With 2015 quickly approaching, we turn our attention to the Marketplace, which is part of the Affordable Care Act (or commonly referred to as “Obamacare”). If you recall from past blog posts, the “Marketplace” is simply an online tool to help you shop for different plans that insurance companies offer.

For 2014, there were essentially only two insurance companies that provided plans on the Marketplace: Anthem Blue Cross & Blue Shield and MDwise. For the year 2015, six new plans will join: All Savers (UnitedHealthCare), Assurant Health, CareSource, Coordinated Care, Ambetter (Managed Health Services), Physicians Health Network, and IU Health Plans.

Not all of these companies will offer policies in every county. For example, IU Health Plans will not be offering plans in the central Indiana area. Not all physicians will also be accepting plans from all insurance companies, either.

This is where things get tricky. How on earth are you supposed to know what a doctor accepts? How do you know which insurance companies are offered in your area?

Let’s start with the insurance company, as it is far more simple. When you log into the Marketplace or seek to purchase a plan directly from the insurance company, they will only show you policies that are available in your area. So, if nothing shows up, then you cannot purchase the plan.

From a provider standpoint, every practice is different. Since we are a private practice, we are afforded the opportunity to make our own decisions on what to accept and what not to. When we make these important decisions, we take into two different factors: what is best for the practice, and more importantly, what is best for our patients. Within those two factors, we analyze a wide range of variables. In other words, we are not in the business of making quick, uneducated decisions.

With all of that said, my overall philosophy (and I know our physicians agree) is that we want to accept as many plans as possible. One might argue this is because we want more business. While I would be lying to you if I told you this was not the case, this is not the only reason. My main focus is to not lose the current patients we already have. We take great pride in the relationships we have built with each of our patients, as you put a tremendous amount of trust in our physicians, nurses, and staff. Changing doctors can be really daunting for anyone, so we try to limit such decisions on behalf of our families.

So, which networks will Riviera Pediatrics apart of? We are currently in-network with Anthem, MDwise, AllSavers, Assurant Health, and Ambetter. We have applied for CareSource, but we have yet to hear back from them. Of course, once we do, I will make sure we post the exciting news on the front of our Web site.

As always, we recommend to all of our patients when selecting a new insurance policy: do your homework! Ask the insurance company if we are part of your network. Unfortunately, sometimes it is very difficult for us to know exactly for sure, as some we are automatically included and some we have to apply. For your peace of mind, double check, that way you do not get stuck with out-of-network costs.

Remember, we are YOUR advocate! However, understanding your insurance is your responsibility. If you have questions, we are more than willing to help you. We will ultimately file claims to almost every insurance, but we cannot guarantee benefits.

Hopefully this helps you and your family move into the new year. Thank you for being such loyal patients. If there is anything I can do to help in any way, shape, or form, please contact me at 317-297-3507, option 6.


Your friend,

Nicholas J. Hannah, MSM

Director of Business Operations

Riviera Pediatrics

UV Sun Safety Tips

July is UV Safety Month. We love seeing our kids running around and having fun outside, but we need to take necessary steps to keep them safe. July is typically a very hot month here in Indiana, and thus, the UV rays are at it’s harshest levels. The following blog entry gives tips and helpful information on how to keep your child safe, but still allows them to have fun outside.

How can we protect our children from the sun?

There are plenty of different ways you can protect your child. First, the sun’s UV rays are at its strongest levels between 10 a.m. and 4:00 p.m. So, it’s best for your child to be outside either in the morning or the evening.

When possible, try to keep your child in the shade. This will keep the UV rays out of sight to allow your child to enjoy being outside without the risk of sun burn.

Keep sun glasses and a wide-billed hat near by, as these items will also be able to protect your child. Children should be dressed in lightweight, cool and comfortable clothing. Believe it or not, but dark clothing is usually the best, as it eliminates the ability for the UV rays to reach the skin. Obviously, when you have exposed skin, use sunblock and sunscreen.

What is the difference between sunscreen and sunblock?

So often, these two terms are used interchangeably; however, there is a difference. Sunscreen actually absorbs UV radiation and dissipates it as heat. Sunblock acts as a physical barrier that reflects the UV radiation off the skin. Many products designed for children (and adults alike) usually contain a combination of both.

What does SPF stand for and how effective is it?

SPF states for “sun protection factor”. All sunscreen and sunblock will have a factor, or number, attached to signify how strong the product is. When applied appropriately, SPF 15 will absorb approximately 93% of the sun’s UV rays. In other words, 7% of the rays will still reach your skin. SPF 30 will absorb 97% and SPF 50 will absorb 98%. Anything higher than SPF 50 will have limited results compared to SPF 50, as it can only protect so much of the UV rays. We do recommend using at least SPF 30 on your children.

How much sunscreen should I use on my child

Use a LOT! So often, people only use about half of what they actually require. Make sure you cover all exposed areas, paying very close attention to areas that people tend to miss, such as the tops of their feet, back of their hands, along the hairline, and their ears. Make sure you apply the sunscreen at least 15 minutes prior to sun exposure to allow it to absorb into the skin.

What about babies?

Babies younger than 6 months have very sensitive skin. We recommend that infants be kept out of direct sun as much as possible. If they are going to be exposed, use an infant sunblock with at least SPF 30.

Now, my child suffered a sun burn — what do I do?

You can care for sunburns by applying a cool compress and aloe vera gel on the exposed areas. You can also administer ibuprofen to help relieve and discomfort (for children older than 6 months).

If you have concerns, please do not hesitate to call our office at 317-297-3507!

Bicycle Safety

Bicycle safety is extremely important for the well-being of your children. For a child, riding their bicycle can be adventurous, exciting and eventful. However, if they are not properly trained and taken the necessary safety precautions, the excitement can turn deadly.

The following tips and suggestions can be extremely helpful to ensure your child has a great time, but also stays safe. Of course, if you have any further questions, please consult your doctor here at Riviera Pediatrics.

  1. Protect your head. Wear an appropriate-sized helmet. Ensure the strap is attached and appropriately adjusted. Make sure the helmet is squarely on top of the head and not tilted backwards.
  2. Stay visible. If the drivers on the road can see you, there is less likely of an accident. We suggest you install blinking lights on the front and back of the bicycle to ensure your child can be seen.
  3. Look, signal, and look again. Teach your child the appropriate hand signals when turning. This helps other drivers know where your child is intending to go. Make sure your child makes eye contact with the driver before proceeding. Never assume the car will stop.
  4. Stay alert. Make sure your child stays focused on the road and other obstacles in their path.
  5. Go with the flow. Teach your child to bike with the flow of traffic, not against.
  6. Act like a car. Drivers tend to get used to a normal flow of traffic from other cars. Teach your child not to weave in and out of their path. Of course, always be aware of your surroundings.
  7. Don’t get distracted. Listening to music or talking on the phone while riding a bicycle can pose a dangerous distraction. A child needs to be able to see and listen to what is going on around them.
  8. Always obey all traffic laws and lights. Disobeying such laws can lead to dangerous results. Make sure your child understands and respects the laws.
  9. Assure bicycle readiness. Make sure the bicycle is properly adjusted both for comfort and safety.
  10. Do a quick bicycle test. Just like we are taught as adults with our cars, make sure the child understands that a well-maintained bicycle is a safe bicycle. Make sure the tires are properly inflated and secure. Also check the brakes to ensure they are functioning properly.

If these simple tips are adhered to, your child is going to be put in a much better position to be safe and successful. Of course, if your child has an accident, please call our office to either schedule an appointment to see the doctor or to speak with a nurse.

Remember, we are here for YOU!

Contemporary Pediatrics: Angles on Earth

Who is a true “hero” when raising a child? The parent. Parents make a huge impact on the overall development of their children. Patience, humility and understanding go a long way in the overall success of your child.

Please click the link below to read a wonderful article in the August 2013 Contemporary Pediatrics, written by Dr. Raghavendra Rao of the Sequoia Family Medical Center in Porterville, California.

Our doctors particularly enjoyed this article, as the mother mentioned embodies who a true hero is. She is an angel who cared for her child when many would not. We all learned a tremendous amount from Dr. Rao’s story, and we hope you do, too.

Angels on Earth

Note: Riviera Pediatrics received expressed written consent from Contemporary Pediatrics to post this article. This article is soley intended to be used for personal purposes, and should not be used in any other way.

What is the Affordable Care Act (ACA)?

Hey, Nick here! Welcome to our new blog. Here, you will find helpful tips that will allow you to better care for your children. I am fully committed, as your director, along with each of your doctors and nurses, to provide you the best possible care. We are on your team, and we will do whatever we can to make sure you and your children feel comfortable. Now, onto the fun stuff…

There has been much talk over the last few months regarding the Affordable Care Act (ACA), or more commonly referred to as “Obamacare”. Here, we will refer to the Act as the ACA. I am sure you have been equally confused, and sometimes frustrated, with the ACA as we have. So, education is paramount to the success of the Act. I have been spending a ton of time researching how the ACA will not only affect Riviera Pediatrics, but you, the patient, as well. Admittedly, I am honestly less concerned about how it will affect the practice, but more concerned about how it will affect you and your family. Moving forward, I will do my best to ensure you have all of the necessary information to make informed decisions. If you do your homework, you should be just fine. Of course, we are your team, so we will be by your side every step of the way.

The ACA is intended to provide those who are uninsured the ability to purchase affordable healthcare. Of course, there are a ton of other intended purposes; however, that is the basic premise. What does this really mean to you, though? Well, the year 2014 is going to be a year of change for the medical industry. As a team, we have been working very hard to prepare for all of the necessary changes, because, yes, things will be different.

I am sure you have heard about the Healthcare Insurance Marketplace, or more commonly known as the “Exchange”. The Marketplace Web site ( has had all sorts of technical issues, which has made “shopping” for insurance rather difficult. The Marketplace is just that — a market for people to go shopping for insurance policies. This is no different than going to, say, the grocery store. Every state has different products on the Exchange that you can choose from. In Indiana, for example, there are two products: Anthem and MDwise. Keep in mind, these two products are separate from any other product Anthem and MDwise might provide through their typical HMO or PPO. If you are eligible to purchase through the exchange, meaning your place of work either does not provide their employees healthcare insurance, or the insurance is not affordable, you can then choose from either product that best fits your family’s needs.

As a practice, we have chosen to accept the Anthem product on the Exchange. So, should you end up utilizing the Marketplace, you would need to choose Anthem to continue seeing our physicians. However, the problem with the Anthem insurance is that IU Health hospitals, St. Vincent hospitals and St. Francis hospitals will not accept the Anthem product from the exchange. (Note: we are currently exploring the option of accepting MDwise; we will have more information on this in future blogs.) For instance, should we need to send you to a specialist at RileyHospital (which is part of IU Health), you would likely have to pay out-of-network fees, which would likely include most of the visit. CommunityHospitals (and other outlier hospitals) in the Indianapolis area is accepting the Anthem product from the exchange, and unfortunately, they do not have the amount of specialists the other hospitals have.

What do you need to do next? The biggest advice I can provide to any of our families is to check their current insurance policy. Talk to your insurance companies or your human resource representative. Ask them how the ACA is going to affect their policy. If you have insurance through your employer, the exchange may not affect you (unless your company purchases the company insurance through the exchange); however, your policy will likely be affected, if it does not meet the ACA standards. Understanding your policy has always been your responsibility, and with these new changes, that will be ever more important. We will do everything in our power to assist you through this process. Yes, things will be confusing, even for us. But, as long as we stick together, we will work through it as a team.

Of course, if you have any questions, please call me. I am here for YOU. I pride myself on being accessible to all of our patients, so if you ever have any questions, just ask for me, and I will be more than happy to help you.

Be sure to check out our new Web site at where we will be posting all kinds of educational information to help you better care for your child. We are also working on a monthly newsletter that will provide helpful tips and news.

For the children,


Nicholas J. Hannah

Director of Business Operations

Riviera Pediatrics