Billing FAQ

Will my insurance plan cover a preventative skin exam?

Our providers are happy to see you for an exam and consultation. Most insurance plans do not cover routine preventative skin examinations. However, most patients have skin spots, birthmarks, lesions, moles or other noticeable skin conditions which may cause concern. Once a condition or lesion has been diagnosed by a dermatologist (whether the spot is benign or malignant), your insurance plan will not consider it “preventative care” and will cover the visit.

How do you determine your fees?

Our fees are regulated by the entity who governs the medical field. As well, many factors are taken into consideration when creating a fee structure. For example, determining what is required in order to provide a specific service to our patients (i.e. resources, supplies, staff assistance). We review local data of the surrounding area to ensure our fees are in line with others providing the same or similar services.

The doctor removed a lesion from my back. Why am I being charged for another surgery to repair it? Shouldn’t that be one charge?

There are two parts to this type of procedure – the removal of the lesion and the repair. The type of removal chosen is dependent on several factors such as size, location and whether it’s benign or malignant. The type of repair functions similarly. The procedure is required to be billed in two parts (removal and repair) because each has specific criteria to meet per insurance coding guidelines.

Freezing of Actinic Keratosis: The doctor sprayed me for half a second – why is it so expensive?

The treatment of Actinic Keratosis involves spraying liquid nitrogen on the pre-cancerous lesions. The cost starts at $145 and increases according to the number of lesions treated. Our fees are in line with other dermatologists in our area who provide the same service.

What will I be charged for Mohs?

Mohs can range anywhere from $2000 to $8000. The procedure consists of two parts – the removal of the cancer and the repair of the wound.

The price for Mohs is determined by the following:

  • The number of stages it will take for all of the cancer to be removed
  • The type of repair needed in order to close the wound

Note: The above cost range is for Mohs surgery ONLY. It does not include fees for:

  • Exam and consultation charge (office visit) same day as surgery.
  • Any additional procedure(s)/pathology (Example: biopsy of different site).
  • Applicable follow up care (determined by the type of care needed for repair of the wound).

Why am I being charged for the biopsy from your office and from somewhere else? Why wasn’t I told it would be sent out?

We strive to provide optimum service to all of our patients. In order to do so, we send your pathology specimen to a laboratory in Alabama for processing and interpretation by a dermatopathologist. The outside dermatopathologist charges for the preparation of the slide(s), called the Technical Component, and the interpretation and report, called the Professional Component. Our doctors only charge for performing the procedure. If you have questions about your pathology bill, you can contact SkinPath directly at 1-866-559-0656 or DermLab at 205-263-8810.

What is a deductible?

An annual deductible is the dollar amount you must pay out of pocket during the year for medical expenses before your insurance coverage begins to pay.

For example, if the policy has a $500 deductible, you must pay the first $500 of medical expenses before the insurance company begins to pay for any services.

This works just like the deductible for your car insurance or homeowner’s insurance policy.

When does a deductible begin?

Your deductible begins at the start of your plan year. Most plan years begin either January 1 or July 1, but plans can start on any date

(The Medicare plan year begins January 1 and the deductible is $147 for 2014.)

When do I have to pay for services?

Any time you receive medical care, you are expected to pay in full for your services until your deductible is met. If you have a very large deductible, called a high-deductible insurance plan, you may have to pay out of pocket for most of your medical services.

How will I know when my deductible has been met?

You can call your insurance company at any time to check on how much of your deductible has been met. Some insurance companies even have this information available online.

What if I have more questions?

Our staff is happy to speak with you about your account at any time. Please contact our billing department at (731) 213-0127.