Frequently Asked Questions
Will my visit be covered by insurance?
- Most visits for skin conditions are covered by insurance, including acne.
What is a participating or in-network provider?
- A doctor who enters into an agreement (contract) to accept a certain amount (“assignment”) from an insurance plan for all covered services provided to all patients who have coverage through that insurance plan. This doctor also agrees to accept the total amount as payment in full with the exception of copays, deductibles and coinsurance. This means that you will not be billed for more than the insurance plan allows. Checks are sent directly to the provider.
Why was my insurance information collected over the phone, before my appointment?
- Just like you, we want to be prepared for your visit. Your insurance information is submitted to your insurance. In turn, we receive your basic policy information; this is a process called insurance eligibility verification.
How do I know if I need a referral?
- The best way to know for sure is to contact your insurance company.
What is a deductible?
- An amount you must pay for health care services before the insurance begins to pay. The deductible requirement starts the day your insurance renews; then deductibles reset every plan year.
Let's say your plan's deductible is $1,300. That means for most services, you'll pay 100 percent of your medical and pharmacy bills until the amount you pay reaches $1,300. After that, you share the cost with your plan by paying coinsurance and copays. The combination of deductible, coinsurance and copays are your Out of Pocket Costs.
What is a copay?
- A small portion of the actual cost of the medical service paid by you at each office visit.
What is coinsurance?
- Coinsurance is your share of the costs of a health care service. It's usually figured as a percentage of the amount the insurance allows you to be charged for services. You start paying coinsurance after you've paid your plan's deductible, if applicable.
Here's how it works. Lisa has a condition where she sees a doctor regularly. She has paid her $1,300 deductible. Now her plan will cover 70 percent of the cost of her office visits. Lisa pays the other 30 percent; that's her coinsurance.
Am I responsible to pay my copay, deductible or coinsurance at my appointment?
- Yes, however to simplify things we may collect a flat base amount known as a deductible prepayment. After your claim is processed by your insurance, there still may be a balance due. We will bill you in statement form of the remaining balance.
How much is my visit going to cost?
- The cost of your visit varies depending on your remaining deductible and the complexity of the visit. Also, procedures and biopsies will increase the amount submitted to your insurance.
Why do I have to pay when I have insurance?
- You are not alone in the confusing world of insurance coverage. There are many who do not realize that their insurance will not pay their medical bill in full. Patients are responsible to pay their copays, deductibles and coinsurances. Unfortunately, the inconsistency of when this money is collected by the various doctors’ offices you visit, make it that much more confusing. You pay the monthly premium for the insurance coverage, but it does not stop there. You are subject to the terms of your policy, which is copays, deductibles and coinsurance.
Why did I get a bill from the Doctor and a laboratory?
- Some insurance plans require testing to be done through a specific laboratory. Therefore, your Doctor performs the procedure and the specimen is sent to the lab for pathology services. Your bill from the doctor is for the removal procedure. The bill from the laboratory is for pathology services.
- What are pathology services? Just as your computer contains electronic information that you cannot see without the monitor, your cells store important information that cannot be seen without a microscope. In cases such as these, the skin samples taken during the biopsies are examined closely under a microscope where a definitive diagnosis can be made.
I have more than one insurance. Who pays first?
- Knowing which insurance pays first depends on a number of things. If you have more than one insurance, you should call each one of them to determine who pays first, second and if applicable, third.
Can I use my health savings account (HSA) to pay my bill?
- Yes, you can. However some insurances issue the HSA payment directly to the doctor when processing your claim. Contact your insurance carrier to find out what type of HSA you have.