Does your office bill my insurance company for office visits and procedures?
Our office participates with many insurance companies and the office billing department submits claims based on several factors:
We bill accordingly—regardless of deductibles and co-pays. If you have insurance we participate with, we MUST bill your insurance company. But if you choose, for some reason, to pay out-of-pocket, you will be charged the same cost as charged to your insurance company. Because of our contract with your carrier, we cannot discount your visit or procedures. If you choose to be seen and do not have insurance, or have insurance we don't participate with, you will be responsible for the visit and any procedures on the day of the visit.
We accept the following insurances:
Every insurance company will send or provide a statement called an “EOB”- Explanation of Benefits. This statement informs you of all the services performed in our office, the amount charged to your insurance company, how much your insurance company paid and if they denied payment with the reason for denial. In addition, you may have a co-pay or co-insurance for which payment is your responsibility. If you have not met your deductible, the allowable amount will be billed to you.
If you still have questions, you may call our office and leave a message for the biller. Please provide your Patient ID number (found on your bill), your name (spelled out slowly) and a phone number that she may reach you.
Bills from hospital laboratories and other laboratories should be discussed with the billing department of that laboratory.
The legal name of our practice is Ronald D. Kerwin MD PC, but be assured, your visit was billed correctly under the physician that treated you: Dr. Ronald Kerwin, Dr. Michael Dorman, Dr. Suzanne Merkle, Dr. Leonard Cetner or Dr. Aaron Cetner.
We make every effort to be up-to-date on which laboratories participate with the many insurances that we accept. We use several laboratories for blood work, cultures and pathology. Our preferred labs are:
If your insurance requires that we use a specific laboratory to avoid unnecessary charges to you, please let the medical assistant/physician know when tests are performed in our office and sent out to a lab. Of course, if you have not met your deductible, you may owe the allowed amount to the laboratory. Again, any problems with lab bills, please call the laboratory in question.
What are your policies for calling in prescriptions?
If you have been to our office within the past 6 months and were prescribed or are continuing treatment with your requested medication, then you may call our office for a prescription refill (No new medications please) during normal business hours. This prescription line (Option 3 on our automated system) is checked periodically throughout the day Monday through Friday. Please allow 24 to 48 hours for your request to be addressed. The following information is required for a refill:
Your physician will consider each request and if not approved, our staff will call you.
In Dermatology, there are several procedures that, although the physician deems them medically necessary, your insurance company may not allow. Some of them have been consistently denied- even when the patient has a "referral" or an "authorization". For those procedures, we cannot bill your insurance company and you must pay at the time of the visit. You will be informed at your visit, which procedures this pertains to and the cost to you.
Cosmetic procedures, such as Botox, Fillers, Laser hair removal and products sold in our office are never covered by insurance. You will be asked to pay for these procedures and products at the time of service/purchase. We accept cash, checks, Visa, MasterCard, Discover and American Express.
Insurance cards must be up-to-date and scanned into our system so that we can make every effort to bill your insurance correctly. If you are not able to provide us with a copy of your insurance card for scanning you will be responsible for payment for the visit. In addition, we verify your address and phone number for our records, since our automated phone system will call you to remind you of appointments or recalls.
If you have an HMO and need referrals to be seen by a specialist, the referral must be at our office at the time of the visit, otherwise, you may re-schedule or pay for your visit.
In addition, the receptionist will need to see your driver's license or identification as a precaution against identity theft. This policy is mandated by the federal "Red Flag Rule" that requires all businesses that extend credit (bill for services) to confirm your identity.
We have recently changed our office Practice Management system which will require a copy of your insurance card, your driver's license, an email address and verification of your phone number so that we may text and or email you important appointment reminders.
We are sorry for any delays this may cause but it is necessary for proper billing and communication.
Your healthcare provider prescribes medications that he or she feels will either cure or control your skin condition, but many times your insurance company requires a "prior authorization" before you may fill your prescripiton. Our office makes every effort to assist you with obtaining an authorization for your medication but there may be other factors that determine the decision of the insurance company and whether they deem the medication is medically necessary or that you have exhausted less expensive or other over the counter treatments before approval. It is ultimately your decision how much you feel you want to pay for a medication- if the drug company provides coupons to lower the cost or an alternate pharmacy to speed up the authorization process we try to take advantage of this for your benefit. Please be patient with our office. We have employees- a Nurse and a medical assistant dedicated to either finding an appropriate alternative with your doctors' approval or going through the proper channels to obtain the authorization. If in the end your insurance company decides to decline the request, your physician will consider the best alternative.