Our Practice Policies

Appointments Policy (including office hours)

Office consultations and visits are by appointment only. Nominal office hours are Tuesdays 8-2.

Because of demand, and days set aside for reconstructions, new appointments for routine conditions may require 1-2 weeks—or longer at some times of the year.

Urgent situations are accommodated as appropriate, usually within a day or two.

We can almost always manage emergency situations within a few hours, assuming surgeon availability.

Privacy Policy

This practice follows the HIPAA Notice of Privacy Practices of Upstate Dermatology.

Practice Payment Policies

Medical Insurance: Our office participates in many medical insurance plans. When making your first appointment please be prepared to provide your insurance ID number and the name and contact information of your primary care physician. At the time of your first visit, please bring your insurance ID card, and referral (if required).

If you have any questions about your medical insurance, we encourage you to contact your insurance company directly.

Billing Questions: If you have any billing questions regarding your medical insurance or patient billing please contact Dermatology Billing Associates, Inc. [125 Oxford Road Casselberry, FL 32730] 888-245-5337.

Participating Provider: If this practice is part of you insurance company's network of healthcare providers (i.e. we are participating), we are obliged to accept the insurance company's terms of payment, and agree to collect any co-payment assigned by the insurance company's rules.

Non-Participatillg Provider: If we are not part of an insurance company's network of health care providers, payment is the patient's responsibility and is due in full at the time services are rendered. You may submit your paid bill to your insurance company for possible reimbursement.

Referrals: Certain health insurance plans require patients to obtain referrals from their Primary Care Physicians. Patients whose plans require referrals are responsible for obtaining the referral prior to being seen at Upstate Dermatology, PC. If the referral is not received prior to your appointment, you will be asked to sign a patient waiver or to reschedule your appointment for a later date.

Cancellations

Appointment Cancellations: If you are unable to keep your appointment, please notify us at least 24 hours in advance or you will be charged a $50.00 cancellation fee.

Insurance Coverage

A Covered Medical Service is one that is—at least partially—the financial responsibility of the insurance company. It is the patient's obligation to know which medical procedure(s) their insurance plan covers. Upon request, we will (if available) supply you with the CPT codes (a number assigned to identify each medical procedure) and the ICD-10 codes (a number assigned to identify a working diagnosis). If you have any questions about your service coverage or your insurance plan, we encourage you to contact your insurance company directly. Contact information is usually located on your health insurance card and/or online.

A Non-Covered Medical Service is one that insurance companies will not pay for. There are situations where a patient has the expectation that a given service will be, or should be, covered—yet where an insurer will invoke a policy provision that exempts them from payment. Common reasons for coverage denial are: treatments for appearance, treatments they consider experimental or unproven, treatments that have cheaper alternatives, or treatments that will only be approved after specified simpler approaches have (with documentation) failed.

We try to warn patients if—in our experience—a requested service is likely to be probelematic But negative insurance determinations in this regard can often seem (and be) capricious.

We encourage patients to contact their insurance company prior to receiving such services, in order to become familiar with corporate restrictions that might apply, and to understand the financial responsibility associated with having the services performed. Payment for non-covered services is the patient’s obligation, and is due in full at the time services are rendered.

Cosmetic Procedures: Insurance providers consider these procedures medically unnecessary, or elective. Fees related to a cosmetic procedure are discussed with patients prior to the performance of the operation. Payment is the responsibility of the patient, and due in full prior to the services being rendered. In these instances, usually no insurance submission is involved—though we can provide a paid invoice.

Our cosmetic surgery fees generally follow a preset schedule of prices which we update from time to time; it is compiled with input from practice expenses, national average charges amassed by the American Society of Plastic Surgeons, and from surveys of prices in the greater Albany area. Fee quotations will be honored for 6 months from the date of the consultation.

Cosmetic Surgery fee payment is due at or before the time of surgery.

Arranging surgery involves the schedules of multiple professional people (surgeon, nurse, assistant) and an operating facility. To date we have avoided the approach—which many other plastic surgery practices take—of requiring a non-refundable deposit to schedule surgery. Instead, we trust patients to get their payments to us in a timely way. However, if full payment and any required medical clearances are not received by the stipulated date, the surgery will be postponed in order to open the facility schedule and professional schedules to other waiting patients.