skip to Main Content

Frequently Asked Questions

The Art and Science of Beautiful Skin.

Frequently Asked Questions

The Art and Science of Beautiful Skin.

DERMATOLOGY AFFILIATES

FAQs

Bring your Driver’s License or picture ID, Insurance Card and Co-pay.

Plan to arrive 10 minutes ahead of appointment time to avoid delays.

Yes, you need to bring your insurance card every visit. The Insurance Commissioner for the State of Georgia has asked that insurance cards be checked at each visit to protect against insurance fraud.

Your insurance company also requires us to check your card at each visit to confirm that we have the most current card and to protect against insurance fraud.

There’s a slight, but important, terminology distinction here.  “Covered” does not equal “paid”.  Your office visit may be a covered benefit, but that does not mean your insurance company is going to pay for the visit.  When calling your insurance company, be sure to specifically ask what you will have to pay, not what is covered. It is likely that at least some of the allowed amount will be applied to your deductible or coinsurance amounts.

The deductible is the amount that must be paid by the patient before an insurer will pay any expenses. As an example, assume your deductible is $500. If you come in to our office and your insurance company processes your claim and allows $150 for the services we provide you, but you have not met your deductible yet, they may give you the responsibility of paying that $150. Since deductibles renew annually, if you have 4 visits like this in a year, at the fourth visit you will have met your $500 deductible, and your insurance plan should pay the remaining $100 allowed.

Co-insurance refers to the percentage of the allowed amount that you are responsible for paying after the deductible is met. For example, a person with 80/20 coinsurance would be responsible for paying 20% of the allowed amount for their medical care after they have paid their deductible.

Full-pay patients (who do not have insurance) pay the retail rate for office visits and procedures. Even if you have a high deductible plan, meaning that you will most definitely have out of pocket expenses, it is wise to file to your insurance because in-network insurance plans usually provide patients with a greater discount than the retail rate. In addition, you will get credit with your insurance company for the money you pay for your healthcare.

There are many reasons why your insurance company may deny your visit, too many to mention here. What is most important to know about claim denial is that if we have sent you a statement, we have confirmed that the denial is not due to an error on our part. Before calling us to find out why your visit was denied, contact your insurance company and ask them. Oftentimes the insurance company needs information from the patient, and this will give them the opportunity to get the information they need to reprocess your claim. If your visit is denied for any reason, the full responsibility of the visit is yours.

Think of your insurance as a form of payment. If your credit card was denied at the supermarket, you would be responsible for contacting the credit card company to find out why, and then paying in cash for the goods at that time. At a medical office we are billing you after the services are provided, but they are still your full responsibility. Our relationship with your insurance company is based around the relationship that you established with them. Not only do you have a better chance at motivating them to action, but most times we do not have the information for which they are asking. We will file your claim to the insurance company that you provide, but we cannot pursue them for payment if they refuse to offer it. The best thing to do is to contact your insurance company, get the name of the person with whom you speak, a reference number for the conversation, and then call us with the information they give you. If we see you actively working with your insurance company to get a claim paid, we are willing to be patient in getting paid by them.

The codes that we submit to your insurance company are determined by our doctors to accurately describe the diagnoses and treatments from your visit. We often receive phone calls from patients stating that we filed the wrong code, and a patient’s insurance company told them to have us re-file. We cannot re-file your visit with different codes to get a different financial outcome, no matter what your insurance company tells you. Dermatological procedures are often considered to be surgeries by your insurance company, and dermatologists cannot file preventative codes. Unfortunately patients are not accurately told these things by their insurance companies when they call with questions about their visit. We have included this information in our financial policy as well, to make patients aware of this before their visit.

Purchase Our Products

If you have any questions about products please call, text or email us.