PAYMENT POLICY EXAMPLES
To minimize cost and maximize care, we have changed the way we do our billing. We now provide documentation for your visit that you will need to receive payment directly from your insurance company. We now have completely transparent billing with no hidden charges. We provide the documentation for you to submit to your insurance company for reimbursement after paying for your services at the time of your visit. With most private insurances, you will pay less than if you went to a physician in network! We are able to provide this less expensive alternative (especially if you have significant out-of-pocket or high deductibles) by passing on the cost savings to you.
For a list of prices and for our policy, see “Policy and Pricing“.
Examples of how this works:
EXAMPLE 1: You have a bleeding spot on your upper back. You are worried it might be cancer. You go in and are examined, have a biopsy, and then are treated for a basal cell cancer.
The insurance-approved costs are:
new patient visit ($110), biopsy ($105), pathology reading ($114) and treatment of the cancer ($173).
Our direct pay costs are:
office visit ($75-100), biopsy ($105), pathology reading ($30), and treatment of the cancer ($125).
Great insurance (no deductible, $20 copay for office visits): At $40, you most likely will choose to use your insurance.
Average insurance ($500 deductible, 20% copay): Depends on whether you’ve met your deductible. If you have had no medical expenses, you will pay the entire $502. If you have already spent $500 on medical care, you will pay $100 (unless you have other deductibles). Direct pay costs less if you haven’t met your deductible, but more if you have.
High-deductible insurance ($3000 deductible): Obviously, you go with the $230-305 direct pay instead of using your insurance and paying $502.
Additional considerations: Often, everything can be done at one visit rather than having to come back for a second or additional visits through regular insurance plans. As an example, if you have multiple lesions to be treated, they can all be done on the same day rather than returning on multiple days.
EXAMPLE 2: You bring in your daughter for treatment of her acne. Her first visit includes the new patient office visit, treatment plan and prescriptions. Two months later, she returns for a follow up visit.
Insurance approved costs are:
new patient visit ($110)
Direct pay costs are:
regular visit ($75-100)
Great insurance (no deductible, $40 copay for office visits): At $40, if cost is the main concern, you use your insurance.
Average insurance ($500 deductible, 20% copay): Again, it depends on whether you’ve met your deductible. If you have had no medical expenses, you will pay the entire $110. If you have already spent $500 on medical care, you will pay $44. Direct pay costs less if you haven’t met your deductible, but more if you have.
High-deductible insurance ($3000 deductible): It makes more sense to go with the $75-100 direct pay instead of using your insurance and paying $110.
Additional considerations:
- Acne visits often entail multiple medications which involve multiple additional copays for each prescription plus the time to go the pharmacy. We work with specialty pharmacies that can provide many prescriptions for a copay cost of $0 to $35 AND they will ship the medications directly to your home at no additional cost! Examples of medications currently available at $0 copay include doxycycline, minocycline, adapalene, benzoyl peroxide, clindamycin. (subject to change)
- Isotretinoin (most commonly referred to as Accutane®) can currently be obtained for $5 a month. (subject to change)
- We also offer non-antibiotic options for treatment of acne as well
Example 3: You have a variety of skin growths that have become both annoying and unsightly that you would like to be evaluated and possibly removed.
Insurance approved costs are:
new patient visit ($110), cryosurgery of 10 benign growths ($80)
Direct pay costs are:
regular visit ($75-100), cryosurgery ($25)
Great insurance (no deductible, $40 copay for office visits): At $40, if cost is the main concern, you use your insurance and no surgery deductible.
Average insurance ($500 deductible, 20% copay): Again, it depends on whether you’ve met your deductible. If you have had no medical expenses, you will pay the entire $190. If you have already spent $500 on medical care, you will pay $80 for your surgery deductible. Direct pay costs less if you haven’t met your deductible, but slightly more if you have.
High-deductible insurance ($3000 deductible): It makes more sense to go with the $100-125 direct pay instead of using your insurance and paying $190.
Additional considerations: We are able to treat a variety of different lesions by multiple modalities for $25 for each ten lesions. So at a single visit, treatment of 3 precancerous lesions (actinic keratoses), 5 benign lesions (seborrheic keratoses/warts) and 2 skin tags would cost a total of $25!