Your insurance plan determines whether you pay all or part of your visit. It is your responsibility to understand your insurance plan. Prior to your appointment, you should verify your insurance benefits, coverage, and network status. Dermatologist are skin specialist, your co-payment for specialist may differ from primary care services. Some insurance plans exclude certain conditions, such as hair loss, sweating, or corns/calluses. Also, many patients have procedures (biopsies, injections, excisions) performed during their visit, these charges are in addition to the fee for your office visit and may apply to your deductible. Our pathology and laboratory services are processed by independent companies, you will receive a separate bill from them for services rendered.
Questions for your insurance company:
1. Do I require a referral or prior authorization to see a dermatologist?
2. Do I have have a co-payment, co-insurance, or deductible for procedures?
3. Will I be responsible for any pathology or laboratory fees?
4. Are there any exclusions for certain conditions (ex. hair loss, acne, sweating, corns/calluses)?
5. Are Telehealth Services covered?
Commonly used billing codes:
- New Patient Visits: 99202, 99203, 99204 (The code used depends on the number of problems addressed and complexity of each)
- Established Patient Visits: 99212, 99213, 99214 (The code used depends on the number of problems addressed and complexity of each)
- Biopsy: 11102, 11103, 11104
- Destruction of benign lesion (ex. freezing wart): 17110
- Injections: 11900, 11901
- Copayment (Co-pay): Fixed amount you pay for a health care service or office visit.
- Coinsurance: Your share of the cost of a health care service. It is usually a percentage of the fee charged.
- Deductible: The amount you pay for health care services before your insurance begins to pay.