INSURANCE INFORMATION

Steel City Dermatology, P.C. is credentialed with multiple, but not all (e.g. Medicaid, worker’s compensation) insurance companies/products. While Steel City Dermatology, P.C. will do its best to communicate its credentialed status (e.g. par, non-par, in-network, out-of-network) prior to services being rendered, the ultimate responsibility of knowing this status is that of the patient’s and/or the patient’s responsible party. Steel City Dermatology, P.C. advises patients and/or their responsible party to contact the patient’s insurer to confirm Steel City Dermatology, P.C.’s network status and the details of their coverage (e.g. co-payments, deductibles, co-insurance, lab contracts) prior to receiving care. As a service to the patients we care for, Steel City Dermatology, P.C. will bill patient’s insurers (if applicable, if Steel City Dermatology, P.C. is credentialed with the insurer/permitted to do so) for the medical services rendered. Payments from this process will be paid directly to Steel City Dermatology, P.C. The patient and/or patient’s responsible party are responsible for providing accurate insurance information, and any fees related to incorrect or invalid insurance information being provided. If an insurer requires a referral prior to receiving medical care at Steel City Dermatology, P.C., it is the responsibility of the patient and/or the patient’s authorized party to obtain such prior to receiving care. If a referral is required, but not in place prior to services being rendered at/by Steel City Dermatology, P.C., any fees related to such will be the responsibility of the patient and/or the patient’s responsible party.

REFUNDS

Refunds are not granted for products purchased or services rendered.

OUTSIDE SERVICES

Despite specimens being obtained while receiving care at Steel City Dermatology, P.C, certain tests (e.g. pathology specimen processing and interpretation through Dermpath Diagnostics, DermTech Melanoma Test, DecisionDx Melanoma via Castle Biosciences) are performed by separate, outside companies. In these situations, patients and/or the patient’s responsible party are responsible for working directly with these companies to remedy any balances due from the services they rendered.

OTHER FEES

The following scenarios will result in the corresponding additional fees being applied to the patient’s account balance due:

Returned Check: $25/Check

Late Cancellation/Missed Appointment: Fees as per Steel City Dermatology, P.C.’s Late Cancellation/Missed Appointment Policy

FINANCIAL RESPONSIBILITY

By electing to receive care at/with Steel City Dermatology, P.C., the patient and/or patient’s responsible party assumes financial responsibility for medical services not covered by their insurer(s), as well as for any services deemed as cosmetic. Some payments for medical services are due at the time services are rendered (e.g. copayments), while others (e.g. unpaid balances after receipt of insurances payments, fees related to missed appointments) are due at the time they are determined/statement regarding such are provided. Payment for cosmetic service(s) is(are) due at the time services are rendered. If a patient’s account balance remains unpaid and is transitioned to a collection agency, the patient and/or the patient’s responsible party assumes all costs of collection (e.g. processing fees, late fees, interest, legal fees, court costs). Patient’s with unpaid balances transitioned to a collection agency may not be permitted to schedule follow-up appointments, until their balance is remedied.

CREDIT CARD ON FILE POLICY

Steel City Dermatology, P.C. is committed to providing exceptional care to all those desiring such from our practice. As part of this goal, it is important that we implement processes to streamline financial transactions. For these reasons, Steel City Dermatology, P.C. is requesting that every patient and/or each patient’s responsible party keep an active credit card securely on file. Notice of any charges (e.g. outstanding deductibles, co-insurances, partially paid claims, fees related to missed appointments) to the card kept on file will be provided in advance, allowing time to remedy concerns prior to. This authorization will remain in effect until cancelled. This authorization may be cancelled by communicating this preference in documented form (e.g. Secure Message) with a 30-day notice.

Steel City Dermatology, P.C. will do its best provide reminders for scheduled appointments. However, it is ultimately the responsibility of the patient and/or the patient’s responsible party to remember their scheduled appointments at Steel City Dermatology, P.C.

Due to the high demand for services provided by Steel City Dermatology, P.C. and the financial losses that result from appointments that are cancelled with less than 24-hour notice (late cancellation) and appointments that are missed due to late arrival (5 minutes beyond the scheduled start of the appointment) or lack of arrival (missed appointment), Steel City Dermatology, P.C. will impose the following fees for late cancellation/missed appointments:

• Medical Dermatology Appointment: $50

• Medical Dermatology Procedure Appointment: $100

• Cosmetic Dermatology Consultation Appointment: $75

• Cosmetic Dermatology Procedure Appointment: $150

Please note that fees imposed due to late cancellation, late arrival, and/or a missed appointment are not refundable, they will not be paid by an insurer, and they cannot be paid using funds from a Healthcare Spending Account or a Flexible Spending Account.  

If two (2) consecutive appointments or three (3) appointments over the span of a year are cancelled with less than 24-hour notice, missed (due to late or lack of arrival), or a combination thereof, the patient may be discharged from care at Steel City.

If there is an unusual/extenuating circumstance surrounding a late cancellation/missed appointment, it is recommended that this information be communicated to the staff at Steel City Dermatology, P.C., so that it can be taken into consideration.

Form Completion Fee: $25/Fee

Medical Records:

Surcharge Fees: