INSURANCE 

Medical and surgical visits will be filed with your insurance carrier. It is your responsibility, as the patient, to verify that your physician or provider is currently under contract with your insurance plan. It is also your responsibility to provide accurate insurance (including secondary insurance) and personal information. If you belong to an insurance company that requires that you have a referral, it is your responsibility to obtain all necessary referrals before your scheduled appointment. Failure to confirm that your insurance is active, the provider is in network and that you do not require a referral may result in your responsibility for any and all charges. 

 

Recent changes in healthcare markets have altered insurance coverages to shift more of the cost of care to our patients. Many policies have higher deductibles which means, even if a procedure is covered by insurance, you may be responsible for the majority or entirety of the visit charges until your deductible is met. Because of the large shift of insurance policies to higher deductibles plans (that are not always transparent to patients and to medical offices), our office will be collecting deposits for procedures from all patients that are due at the time of service. These deposits are estimated based on our best efforts; however, any differences will be billed or credited to you. 

 

Per your contract with your insurance company, a co-payment or co-insurance may be due (in addition to the deductible as mentioned above). Like the deductible, co-payment and/or co-insurance are calculated based on our best efforts; however, any differences will be billed or credited to you. You will be responsible at the time of service for the payment of such copays or co-insurance, as well as any past due balances. 

 

It is possible that your insurance company may not cover services or may deem services not medically necessary. If this were to occur, these charges become your responsibility. Your insurance coverage and benefits are a contract between you and your insurance company. Therefore, all disputes must be handled between you and your insurance company. 

We are contracted with multiple insurers to accept assignment of benefits. If you have insurance coverage under a plan with which we do not have a contract, you will be treated as a “self-pay” patient. 

 

Claims not paid within 45 days by your insurance company will become your responsibility, it is your responsibility to contact your insurance company for reimbursement. 

 

CREDIT CARD ON FILE 

Due to the era of medicine and working with high deductible plans that are not always readily available to working practices, we will be obtaining a credit card to be put on file from all patients. 

 

The credit card on file will be charged within 2 (two) weeks of your insurance processing the claim for your visit. If the credit card is denied, you will receive a statement with your balance due to our practice based on your insurance plan. Any balances not paid within 2 weeks of the statement will be sent to collections. 

 

We reserve the right to charge the card on file for the amount due per your insurance, for your deductible, or for the full amount if you are a cash pay (self-pay) patient, have a high deductible, have purchased cosmetic services, have purchased any of our products or for any other past balances due. We will collect all self-pay and cosmetic balances due at the time of your appointment to avoid any future statements. We will use our quote tool to give you an estimate of your balance if you have a high deductible plan. This is not available for all insurance plans and is not a guarantee of price, you will be asked to sign your quote stating you understand this. 

 

If you decline to put a credit card on file, we will not be able to see you as a patient. Only some exceptions may apply and will be determined by the practice manager. 

 

LATE CANCELLATIONS & MISSED APPOINTMENTS  

To make sure we are taking care of all patients in a timely manner, we do have a 15-minute no-show policy. If you are running late, please give our office a call to ensure that the physician/provider is still able to see you.  We understand that unexpected events occur. When this happens, please call our office as soon as possible to inform us of such issues.  

Missed appointments for routine office visits are subject to a $50 no-show fee if not canceled 24 hours prior to your appointment. Missed appointments for surgical or cosmetic visits are subject to a $100 no-show fee if not canceled 24 hours prior to your appointment.  

 

CERTIFIED MAIL 

At times certified mail may be sent out to patients that can’t be reached for reasons such as outstanding skin cancers, insurance changes within the office, patients in a pre-collection status, etc. A $15.00 charge will be applied to the card on file in the event that a certified letter must be mailed. 

 

COSMETIC SERVICES  

By definition, these procedures are not covered by insurance companies; and this office does not submit claims on their behalf. A deposit will be taken when a cosmetic appointment is made. A cosmetic consultation costs $250 and will be collected at the time of scheduling the appointment. $150 of the deposit is applied towards the balance due for any cosmetic treatments received within 3 months of the consultation. If you fail to keep your cosmetic appointment or do not cancel 24 hours in advance, $100.00 of the deposit will not be returned. Charges for cosmetic services must be paid in full at the time of service. 

 

PATHOLOGY & LABORATORY FEES  

Biopsies are sent to an outside pathology lab. You will receive a separate bill from the pathology lab. Microbiology and other laboratory tests are performed by a separate lab that will bill you separately. Please contact the laboratory directly for questions regarding pathology or laboratory bills. 

 

REQUESTS FOR MEDICAL RECORDS  

Our practice utilizes an electronic medical record system which has a secure online patient portal available to you at no charge. Printed copies of your medical records are available at a fee of 60 cents per page plus the cost of postage. Medical records may be sent to another medical provider at no charge. 

 

METHODS OF PAYMENT 

Pacific Crest Dermatology accepts the following forms of payment: Cash, Personal Check with proper identification (valid Driver’s license or photo ID), Visa, Mastercard, and Discover. A $30.00 overdraft charge will be added to the insufficient funds amount of any returned checks. 

 

COLLECTIONS AND OUTSTANDING BALANCES 

Any outstanding balance after 60 days of the date of service may be referred to an outside collection agency. Accounts turned over to collections for non-payment will be charged a $30.00 collection fee. Patients with unpaid accounts or accounts which have been sent to collections may be discharged from our Practice.