Financial

Explanation of Insurance and Billing Policy

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Howard S. Goldberg, MD Inc in Swampscott, Massachusetts, would like to communicate that it is important that you understand your health insurance benefits especially when seeking treatment. If you have any questions about your policy, you should contact your insurance carrier.

 

Dermatology Billing can be complex.  Many Dermatology procedures done in our office may be considered outpatient surgery by your insurance carrier.  Other procedures that do not pose a health threat may be considered cosmetic by your insurance carrier. Examples include but are not limited to skin tag removal, or corn and callous treatments.  We are required by law to bill according to the services that are rendered by your provider and cannot alter our billing to get you coverage for things your insurance will not cover.   Biopsies are a common procedure in Dermatology and will have corresponding pathology charges.  Please be aware that pathology services are broken up into two parts by your insurance carrier.  You may also receive a bill from a laboratory, this is a separate company and service from our practice.  This is for the technical component or slide preparation of your specimen.  Our office will bill you for the professional portion (reading and interpretation) of the slide, this is conducted by a dermatopathologist.  This is an additional service and separate from the procedure conducted by the dermatologist that biopsied or removed your lesion for evaluation.

FAQs

Deductible:

This is the initial dollar amount you must pay before your insurance company begins paying for health services. Your insurance carrier determines your deductible, when you choose your policy.

 

Coinsurance:

Coinsurance is the share or percentage of covered expenses you must pay in addition to the copay and/or deductible. For example, your policy may pay 80 percent of covered charges after you pay the deductible. You would then pay the remaining 20 percent as coinsurance.

 

Copayment

A copayment is a specified dollar amount you pay, as a subscriber to a manage care plan, for covered health care services. It is paid to the medical provider at the time the services are rendered.

 

Referrals:

If your insurance carrier requires a referral and/or authorization, it is your responsibility to obtain the necessary approvals before your scheduled appointment. Without a referral from your insurance carrier, your visit will not be authorized and will not be paid.

 

Payment Due

Your deductible and coinsurance or copayments are your responsibility. Also, visits not covered for not having referrals will be billed to the patient. All balances are due within 30 days of receiving a bill unless payment arrangements are made with the billing office.

 

Cancellation, Rescheduling and No-Show Policy

In the event you need to reschedule or cancel your appointment we kindly ask that you notify us immediately.  Patients who fail to show for their appointments and who do not notify the practice at least 48 hours in advance are costly to the practice and prevent individuals who need to be seen from getting a preferred appointment time.  Patients with repetitive last-minute cancellations or no shows will only be scheduled as a same day appointment if the schedule allows, and therefore may need to call daily.

Policy Regarding Payments

Howard S. Goldberg MD Inc and Cosmetic Dermatology & Aesthetic Laser Center has instituted the following policy regarding payments and billing:

We strongly encourage you to know your insurance benefits. We participate with most major insurance carriers; however, we cannot guarantee inclusion within your specific plan. Many procedures are considered medically necessary and covered under insurance, however this does not mean that you will not incur out of pocket costs due to coinsurance and deductibles as determined by your plan. Upon your request we would be happy to provide you with the diagnosis and procedure information so you can contact your insurance carrier for a quote on patient responsibility prior to treatment.

 

If you do not have insurance coverage or your treatment is cosmetic and not considered medically necessary, payment is due in full at the time of service.  We are happy to provide a good faith estimate ahead of time.  For your convenience we accept: Cash, Check, Mastercard, Visa, AMEX and Discover. There is a fee for NSF checks returned by the bank. Financing programs are available through our office and CareCredit. Please contact our billing department for more details on this program: 781-598-4040.

 

Product Returns:  Unopened purchases may be returned within 60 days for a full refund.  We offer boutique credit only for any opened merchandise returned within 60 days.  There are no refunds, exchanges or credits after 60 days from purchase.

 

No Surprise Act:  Understand your rights against surprise medical bills.  This act protects individuals from receiving surprise medical bills when receiving services from an out-of-network provider.  View details here.

 

HIPPA – Notice of Privacy Practices View details on this page.

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Book your Free Cosmetic Consultation!