Insurance and Billing
Insurance Information: Your Records
Please note:
Please be sure to bring your current insurance cards and a photo ID with you to each visit. We will need to keep current copies in your records.
We accept most insurance plans. Most insurance plans and managed care payers have policies that require co-payment at the time of service. You will be responsible for payment of all co-pays and any outstanding balances at the time of visit. If you are covered under an HMO or other managed care plan (Point of Service or PPO) there may be specific coverage limitations. If services are not covered under your insurance plan you are responsible for payment. You will be required to pay for such services at the time of the visit.
You need to have the following to verify coverage prior to making your appointment:
- Current insurance card – make sure you have your current insurance card (from this year)
- Active plan – make sure your current insurance plan is active and ask what skin care providers are in your network
We will verify eligibility and benefits:
- Coverage will vary based on the type of service and provider.
- If you have an HMO, we will need an active referral for dermatology services.
NOTE: We can verify eligibility and some of your benefits. For all benefit information, reach out to your insurance carrier. Ultimately, you, the patient, are responsible for understanding your insurance coverage and for ensuring your services are covered and/or paid.
Your Healthcare Benefits: Insurance Coverage
If there is any question about our participation with your insurance, please contact our office with your insurance information. We will do our best to help you interpret your healthcare benefits and coverage requirements. However, it is your responsibility to understand which services are covered and which are not covered under your plan and if both our physicians and our outpatient facility participate with your insurance. Likewise, it is your responsibility to identify any coverage changes that may be initiated by your employer or managed care plan. If you have any specific questions, we encourage you to contact your insurance company prior to your appointment. Our billing will include doctors professional fees as well as outpatient surgical facility fees.
If you have difficulties understanding or paying for our services, we encourage you to discuss your problem with our billing office staff.
Please see the insurance and billing policy information below and contact our office if you have any questions.
As a courtesy to you we will bill your insurance carrier if you provide us with complete insurance information. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract. If your insurance company has not paid your account within 30 days, the balance will be assessed to you for payment. You should remit payment within 30 days or contact your insurance company to check the status of the claim. Please notify us immediately upon contacting your insurance company or if there is anything we can do to help settle this claim.
Your Payments: Billing Procedures
We will bill your insurance carrier for you.
You will be asked on your appointment date to pay for services not covered by insurance. This includes deductibles, co-pays, and co-insurance amounts, occasionally office visits and cosmetic procedures. We accept cash, check or credit cards.
Some insurance plans apply separate co-pays for both the office and the outpatient facility. You will be responsible for both.
After 30 days, if insurance has not processed the claim, it will become your responsibility.
More Insurance Information
If your plan requires a referral for specialist office visits, please obtain one prior to your scheduled appointment. If you do not have a referral at the time of your visit, you will be asked to reschedule your appointment or to sign a waiver stating you understand you will be financially responsible for the bill.
Payment in full for cosmetic procedures performed in the office is due at the time of the procedure. We will not bill and will not accept post dated checks. Removal of skin tags or seborrheic keratosis, which were previously covered by insurance, are now deemed not medically necessary and will be considered an out of pocket charge.
As of this time, we have no way of knowing what someone’s deductible is. Procedures tend to be expensive (freezing, biopsies). If you have a high deductible and would like something removed, you might want to check to see if your deductible has been met or how much you would be responsible for if you have a procedure done, prior to your visit. We cannot discount services you receive if you have a deductible. We are contracted with insurance companies to bill the full amount we would bill to any insurance company.
Due to the constant changes in our healthcare system today, many insurance providers are now charging additional co-pays or co-insurance amounts for any in office procedures that are performed. This includes but is not limited to skin biopsies, freezing (including warts and pre-cancerous spots etc.) and skin cancer surgeries. If you have any questions regarding these changes please contact your insurance provider for further clarification.
Please be advised that we use DermPath Labs for pathology and Quest Labs or LabCorp for bloodwork. However, if your insurance is lab specific for another lab, we ask that you tell our staff prior to any services to avoid any unnecessary costs to you.
We accept most insurances including Medicare, but not Medical Assistance. Please call to confirm that we participate in your plan.