| BEFORE YOUR APPOINTMENT (PATIENT’S RESPONSIBILITY) |
Before scheduling your initial appointment, we strongly recommend that you reach out to your insurance carrier to confirm that our office and providers are in-network with your particular plan. Keep in mind that even if we have a contract with your insurance company, some plans may still be considered “out-of-network.” In such a case, your insurance carrier would not pay for services you would receive at Northstar Dermatology. We always advise that you double check so you aren’t stuck with an unexpected balance!
Also, please confirm with your insurance company if your particular plan requires a referral from your Primary Care Physician (PCP) to see a specialist! Most HMO plans will require a referral, but some PPO plans might require one as well. Unfortunately, your insurance will not always tell us if you need a referral, so it is in your best interest to confirm directly with your insurance. If your insurance plan requires a referral, it is your responsibility to obtain the referral from your PCP prior to your appointment at our office. We will make our best effort in securing the referral, but it is your ultimate responsibility to follow up with your PCP’s office to ensure they send us your information. If we do not have your referral on file at the time of your appointment, you will be responsible for the full cost of your visit.
| QUESTIONS TO ASK YOUR INSURANCE COMPANY: |
1. Is Northstar Dermatology and (provider name) considered an “in-network” provider with my plan?
2. Does my plan require a referral from my primary care physician to see a dermatologist?
3. What are my benefits for a specialist office visit? Do I have a copay, or a deductible?
4. What are my benefits for any procedures performed in the office? Will the procedures be covered with my copay, or will they apply to a deductible?
5. Does my plan cover any lab tests or pathology tests that may be needed following my visit at Northstar Dermatology? (Lab tests are performed by separate lab facilities, such as Quest Lab).
| INSURANCE WE ACCEPT |
Due to the constant changes in the insurance market, certain plans may not be listed below. If you do not see your insurance on this list, we recommend that you call your insurance and check if we are a participating provider with your particular plan. Also, keep in mind that even if your insurance company is listed below, there can be exclusions with certain plans. Be sure to confirm with your insurance company that your specific plan is in network with our clinic.
- Aetna PPO/HMO/EPO/POS
- Aetna Medicare Advantage PPO/HMO
- AARP Medicare Advantage
- BlueCross BlueShield PPO/HMO/POS/Federal
- BlueCross BlueShield Medicare Advantage PPO/HMO
- Blue Advantage HMO Exchange
- Care N’ Care (Out-of-network benefits)
- ChampVA
- Cigna
- Cigna Medicare Advantage
- Coventry
- First Health
- Friday Health Plan
- Galaxy Health Network
- GEHA (United Healthcare Shared Services)
- GPA (Group & Pension Administrators)
- Healthcare Highways
- HealthSmart Accel/PPO/HPO
- Humana Choice Care
- Humana Medicare PPO/PFFS/HMO
- Imagine Health
- Imperial Medicare Advantage
- IMS (Independent Medical Systems) PPO
- Medicare Part B
- Partners Direct Health
- PNOA
- Mutual of Omaha Medicare Advantage
- PHCS/MultiPlan
- Railroad Medicare
- Scott and White Health Plan
- United Healthcare
- UMR
| INSURANCE FAQ's |
Will my visit be covered by my insurance? Most dermatology services are considered medically necessary by insurance. However, this does not mean that your insurance will pay 100% of the cost of your service. This is completely dependent on your Specialist Office Visit and In-Office Surgical benefits (you’ll want to call your insurance for your plan benefits). Services that are typically NOT covered by insurance include treatment or removal of cosmetic moles, skin tags, milia, seborrheic keratoses, and cherry angiomas. Not to worry – we have very reasonable pricing for treatment of the cosmetic lesions listed above. Finally, some insurance plans may have coverage exclusions for certain diagnosis (like certain types of hair loss, or acne). We advise that you contact your insurance directly to see if your particular plan has any exclusions for dermatology services.
How much will I have to pay? If you have insurance, your patient responsibility amount depends on your particular insurance benefits. Keep in mind that there are many different insurance plans, and member benefits vary from plan to plan. We advise that you contact your insurance directly to find out what you will pay for your Specialist Office Visit and any In-Office Surgical Procedures you might have.
What if I don't have insurance? No problem! We offer self-pay discounts for our office visit exams as well as surgical procedures. A new patient exam ranges from $150-$200 depending on the level of visit. If you need a procedure performed in office, we would be happy to provide you a quote after you are evaluated.
