Six things
What we will and will not tell you about money
Medical and cosmetic are billed differently, and you are told which before you sit down
A rash, a changing mole, acne, psoriasis, a biopsy or skin surgery is medical care and health plans generally cover it. Treating a mark left behind purely because you dislike how it looks is cosmetic and they generally do not. The line is not always where people expect, so we say which side your appointment falls on at the start, and we put it in writing rather than letting you find out from an invoice.
We can tell you what we will charge; we cannot tell you what your plan will pay
We do not have your plan in front of us, deductibles reset, and coverage varies by employer within the same insurer. Anybody who promises you a number is guessing with your money. Telephone the number on your card, ask what your deductible is and whether dermatology needs a referral, and you will avoid the single commonest unpleasant surprise in this speciality.
The laboratory bills separately, and this surprises somebody every week
If a biopsy is taken, the sample goes to a pathology laboratory, and that laboratory invoices you directly. It is a separate bill from a separate company for reading the sample, and it arrives weeks later. Our self-pay biopsy price of $275 includes it; if you are using insurance, the laboratory's bill is between you and them and we will tell you that before we take the sample.
The self-pay price is the price
What is on /pricing.html is what you pay if you have no coverage. There is no facility fee, no charge that appears at the end, and nothing to pay for the appointment that checks the result of a procedure we performed.
We do not sell packages or memberships
Where a treatment genuinely needs a course — phototherapy, patch testing, a series of wart treatments — you pay per session as you have it and you can stop after any of them. A discount for committing in advance is a reason to keep attending that has nothing to do with your skin.
Tell us if cost is the reason a plan is not working
It very often is, and it is a clinical problem rather than an awkward one. There is nearly always a cheaper generic, an older medicine that works nearly as well, or a way to stage treatment across months. We cannot solve what we are not told about, and a plan you cannot afford is a plan that will not be followed.
Questions
Insurance and fees — the questions we are asked most
Do you take my insurance?
Telephone and ask, with your card in your hand. What we will not do on a website is publish a list of plans, because network participation changes, the same insurer's coverage differs by employer, and a list read six months out of date is worse than no list.
What is the difference between medical and cosmetic here?
Broadly: treating disease is medical, and changing appearance where there is no disease is cosmetic. A changing mole, acne, psoriasis, a biopsy and skin surgery are medical. Removing a harmless mole because you dislike it is cosmetic. The line is not always where people expect, which is exactly why we say which side you are on at the start.
Will I get a bill I was not expecting?
The one that catches people is the pathology laboratory's, which arrives separately and weeks later if a biopsy was taken. We tell you about it before the sample is taken. Beyond that, our self-pay prices are complete — no facility fee and no charge for the visit that reviews the result of a procedure we performed.
Do I need a referral?
Not to book here. Some plans require one from a primary care physician before they will pay, which is a rule about your coverage rather than about our door. Check the number on your card.
Self-pay prices are published in full. Every price this practice charges is on /pricing.html, including the ones most practices leave to an enquiry.
A named diagnosis and a written plan you leave holding
Book an appointment
Pick a physician and a time from the calendar — it shows only the hours each of them genuinely has free. A new patient appointment is thirty minutes, a full skin examination forty-five, and you leave with a named diagnosis written down. If something on your skin has changed, telephone instead and say that word: it is triaged differently.