Billing & Insurance

Dermatology is considered a specialty in the medical world and we frequently perform procedures in addition to speaking with you about skin concerns. Your insurance plan determines whether you are responsible for paying all or part of your visit, it is your responsibility to know what your plan pays for. Many insurance plans have different pricing for specialty visits.  Also, many of our patients have surgical procedures performed during their visit. Specialty office visits include verbal treatment plans, over the counter drug recommendations and prescription drug management. Surgical procedures include any procedure done in the office (surgery, biopsies, destructions/freezes, injections, PDT, and UPT’s). It is important for you to know if your plan has a deductible, surgical deductible, or has different prices for specialty visits.

For questions regarding billing or insurance, email our billing department at billing@audubondermatolgy.com. 

Questions you may want to ask your insurance company before your visit to Audubon Dermatology.

1. Do I require a referral or prior authorization to see a specialist doctor?
2. Do I have a Surgical-Procedure copay and/or deductible?
3. Will I be responsible for any laboratory or pathology fees?
4. Am I covered for Outpatient services in a non-facility setting?
5. Are there any exclusions for certain conditions? For example, some plans do not cover acne, hair loss, hyperhidrosis, corns and calluses, etc.
6. Are Telehealth Services covered under my insurance plan? (i.e. Virtual Synchronous visits, Telephone Consultations, and Store-N-Forward Asynchronous visits)

Below are the most common insurance codes for Dermatology visits:

• New Patient Visits: 99202 or 99203 (modifier -95 or -GQ for telehealth)
• Established Patient Visits: 99212, 99213, or 99214 (modifier -95 or -GQ for telehealth)
• Biopsy/Destructions (Lesions of concern procedures): 11102, 17110, 17000
• Injections (Acne, Scar, Hair Loss): 11900
• Mole Mapping (TB Photography): 96904
• Misc. information you may need when calling your insurance: Tax ID #: 20-4264241, place of service-11,

If you have a deductible within your insurance plan, (medical, surgical, and/or laboratory) you are responsible for any charges until your deductible is met. Here is a little cheat sheet on the most common types of insurance plans.

• Strictly Copay Plans:  You pay a fixed amount per visit.
• Strictly Deductible Plans: You pay the allowed amount contracted by your insurance plan for the services rendered by a medical office until you reach your deductible. After you have reached your deductible, you may be subject to a coinsurance percentage until your Out of Pocket Max has been met for the calendar year.
• Office Copay & Surgical Deductible Plans: A combination of the above two types of plans. It is your responsibility to know your plan.

ACCEPTED INSURANCES: