In dermatology, some surgical procedures are done in the office such as biopsies, growth removal, cryosurgery (“freezing”), destruction of warts, Mohs surgery, excisions, cancer surgery, etc. For many patients, such procedures “go toward the deductible.” This means that the patient is responsible for payment for the procedure (at the amount allowed by the insurance company). In today’s technological world, medical offices and insurance companies try to communicate so that what the patient will likely owe can be calculated in the office as accurately as possible. We do our best to communicate with your insurance company prior to your visit to estimate what your portion for that day will be (including copay, coinsurance and/or deductible). Procedures can change on the day of surgery and your insurance company’s policy can also change. For this reason, we do require a credit card on file for every medical visit. Once you receive your explanation of benefits in 30-90 days, we also receive a copy of this. The insurance company will tell both of us what proportion they paid and what part of the bill you are responsible for. Once we receive this explanation of benefits from the insurance company, we will send you a statement in the mail. 5 days after the statement is mailed to you if we do not receive a check or a call from you, we will bill the balance to your credit card on file.
Medical Insurance
Insurances accepted at St. Petersburg Skin and Laser:
- Medicare
- United Healthcare
- Bluecross Blueshield/Anthem
- Aetna
- Humana
- Baycare
- Simply Healthcare
- Sunshine Health - Medicare
- Ambetter -55+ years old
- Cigna
Additionally, Dr. Kesty does see patients on a fee-for-service (or self-pay) basis. Please call our office at 727-474-9399 or your insurance company for more information and/or to determine if we are an in-network provider.
Understanding Insurance
It is important that you understand your insurance policy. Everyone’s insurance policy is different. Some insurance covers all services (office visits and procedures). Some insurance pays a percentage of the charges for office visits and procedures. Most have co-pay charges for office visits and a “deductible” for procedures (surgery and certain tests). The “deductible” is the part that confuses many patients. Patients often assume that everything done in a doctor’s office is covered by the co-pay. This is not true for most patients. When a patient has a “deductible,” it means that the cost of office procedures (such as surgery and certain tests) is the patient’s responsibility until the deductible is met.
The day of your visit, you will be required to pay your co-pay and/or any unmet deductible or co-insurance for any procedures that you have done in the office. When you have a haircut, payment is due after the cut. When you buy groceries or other products, payment is due at check-out. Medical services are now the same. Your portion of payment is due at the time of service i.e. before (or after) your visit. We encourage you to call your insurance company (the number on the back of the card) for the most 'up to date' information regarding your insurance plan. We have a Financial Policy that all our patients are shown before their initial visit that outlines our agreement with our patients.
Why do I need to provide a credit card to have on file?
By leaving an authorized payment method on file, we can ensure that payment is processed on a timely basis. You will receive notification via email, traditional mail,and/or phone/text before we charge any balance to your card.
What is an out of network provider?
An out-of-network provider is one which has not contracted with your insurance company for reimbursement at a negotiated rate. Health plans generally offer coverage for out-of-network providers, but your patient responsibility can sometimes be higher than it would be if you were seeing an in-network provider. We encourage all our patients to contact your insurance company prior to your visit such that you fully understand your insurance policy as it pertains to out of network care.
Good Faith Estimate
The Good Faith Estimate shows the costs of items and services that are reasonably expected for your healthcare needs for an item or service.The estimate is based on information known at the time the estimate was created.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.You could be charged more if complications or special circumstances occur.If this happens, federal law allows you to dispute (appeal) the bill.
If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date of the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount To learn more and get a form to start the process, go toWWW.cms.gov/nosurprises/consumersor call 1-800-985-3059 For questions or more information about your right to a Good Faith Estimate or the dispute process, visit WWW.cms.gov/nosurprises/consumersor call 1-800-985-3059