Understanding Insurance

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.

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 reduced 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 very 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 owe to St. Petersburg Skin and Laser. 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.

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.