Agreement To Pay
Payment is required at the time services are rendered unless the patient is covered by an insurance company with which Skin Solutions Dermatology participates. It is the patient’s responsibility to know if we are “in-network” with their insurance plan. We accept payment in the form of check, Care Credit, and/or credit card (Visa, MasterCard, Discover, and American Express).
It is the patient ‘s responsibility to present accurate, current insurance coverage information at check-in. Patients will be asked to pay for all services not covered by their insurance including deductible amounts, co-pays, past due balances, as well as balances due resulting from invalid insurance information. HMO coverage or other third party insurance often requires authorizations. Patient will be held responsible for payment if a referral authorization is not provided at the time of service.
Patients understand that failure to make payment when due is the basis for legal action, and agree to pay any and all cost of collection, including but not limited to attorneys’ fees.
Patients authorize and request that payment by an authorized insurance company be made payable to Skin Solutions Dermatology & Skin Cancer Surgery, PC on their behalf for the services furnished to them by our providers.
Medicare Policy
Patients request that payment of authorized Medicare or Medigap benefits be made on their behalf to Skin Solutions Dermatology for any services or items rendered or furnished.
Patients authorize any holder of medical information about them to be released to the Centers for Medicare and Medicaid services and its agents and/or Medigap carrier in order to determine benefits payable for related services.
No Show & Late Cancellation Policy
Out of courtesy to patients in need of care and your provider, patients are required to give 48 hours’ notice when canceling or rescheduling appointments to avoid a late cancellation fee. After two instances of no-shows or late cancellations/rescheduling for an appointment and/or one instance for a surgery, patients may be dismissed from the practice. To avoid dismissal, patients will be required to keep a card on file that will be charged a $75 late cancellation fee for appointments and $150 for surgical appointments if insurance permits. All cosmetic appointments require a $75 fee to book that will be applied towards the visit or used as a no-show or late cancellation fee.