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Insurance FAQs

The Art and Science of Beautiful Skin.

Insurance FAQs

The Art and Science of Beautiful Skin.

DERMATOLOGY AFFILIATES

Insurance FAQs

We accept most insurance brands, however we cannot guarantee that we are in-network with your particular plan even if we accept that brand of insurance.  To make sure we are in-network with your plan, contact your insurance company and ask if we are an in-network provider for your plan.

Important Note: Since insurance benefits are unique to each patient’s insurance coverage, it is your responsibility to know your insurance benefits PRIOR to service being rendered.  We are not responsible for unpaid amounts as a result of deductibles or denials from your insurance company.   We can never guarantee insurance coverage for any service provided.  You are responsible for charges denied by your insurance company.

Medical Insurance Terms

Billed Amount – the full cost of an office visit or procedures performed at our office.

Allowed Amount – the amount your insurance company allows us to receive for the services we provide. Pricing is different per plan and is set by your insurance company.

Adjustment Amount – the difference between the full cost of our services and what an insurance company allows us to receive as payment; the ‘insurance discount’. As long as a claim is processed as in-network, the adjustment amount is written off, and is never passed on to the patient.

Date of Service – the date of your visit.

CPT® Code – Current Procedural Terminology (CPT®) code; codes created by the American Medical Association to describe the treatments or services provided to you by your doctor. These codes are standard across all insurance companies, and allow physicians to bill uniformly.

Diagnosis Code – Also known as the International Classification of Diseases (ICD-x) code, this was developed by the World Health Organization. American medicine is currently using the ICD-10 code set or the ninth version. These codes are used to identify and describe a patient’s illness or symptoms. These codes work in conjunction with CPT codes.

Explanation of Benefits –The EOB is a statement detailing how a claim was processed by your insurance company. It usually lists the CPT® codes, the diagnosis codes, the billed amount, the allowed amount, the adjustment amount, and any amount paid by insurance or responsibility given to the patient. The EOB also lists denied claims and gives reasons for denial.

Deductible – A set amount that must be paid by the patient before an insurance company will pay any expenses.

Contact Us Today

Have questions or concerns? Please call us at 404.816.7900