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Derma and Aura Patient Handbook

Introduction

Welcome to Derma and Aura Skin & Laser.  We are happy to have you in our practice. We have created this handbook as a means to explain our policies and make your experience with us a pleasant one.  In the hectic world of medical dermatology, sometimes key issues in the everyday operation of our clinic, though second nature to us, are not always well understood by some of our patients, leaving them uninformed and confused.  This handbook attests to our care for you and our goal in building a strong positive relationship with our patients, their families and friends.  Thank you for your attention and if you have any questions, please ask a member of our staff for help.

Philosophy

Our goal is to provide honest medical skin care with an emphasis on education and ethics.  We are committed to providing you with the information you need to make appropriate choices concerning your particular dermatologic condition.  We believe in the down-to-earth approach of letting people choose their own path using our guidance.  All of this is best achieved in the professional and yet relaxed environment of Derma and is reflected in our personalities, demeanors, and office atmosphere.

The Science and Art of Dermatology

The practice of dermatology is a purely visual expertise.  Our practitioners usually only need a glance to diagnose a myriad of conditions, cancers, and ailments.  But behind the glance of a medical dermatologist stands four years of undergraduate college, four years of medical school, one year of internship, three years of dermatology residency training, a two day board certification examination, and years of private practice experience.  Our other healthcare providers have either equal or similar qualifications.  So please do not judge your quality of care by time alone.  Judge it by the honesty, training, and experience behind it.

The Wonderful World of Insurance
The Process

How did the world of medical insurance become so convoluted?  Your guess is as good as ours.  Realize this–though we accept many insurance plans and deal with them daily, our relationship with them is far from ideal.  We sign-up with insurance plans to allow us to see you and then we arrange contracts delineating our reimbursement rates for our services.  After we provide our services to you, we bill the appropriate insurance companies for our payment (though some offices have implemented a policy of making their patients submit their own claims).  It should be a simple transaction but the sad reality is that we usually only get a reduced or minimal payment from your insurance companies.  Sometimes they avoid payment entirely and sometimes they delay payment for sixty days or more to generate more interest returns on money owed to us.  For the Derma staff, it is a daily battle with insurance companies and their unwillingness to pay.  With these issues always looming upon us, we have to strictly enforce our policies regarding proof of insurance, copays, deductibles, and referrals.

Proof of Insurance

For us to attempt to bill your insurance, we must have proof of a current insurance plan, usually in the form of an insurance card.  If you do not have your insurance card or it is not up to date or it is not on file with us, then we cannot bill your insurance for that day’s services.  A Derma healthcare provider cannot see you otherwise, unless you pay for the visit yourself.

Copays

Copays are charges that you have accepted under your insurance plan to pay yourself when you utilize medical services.  All copays are due at the time of an appointment.  Copays cannot be waived.  We are obligated by written contracts with your insurance companies to collect these fees, allowing them to discount their payments to us by the same amounts.

Deductibles

If you have a deductible, this means that for each calendar year you are obligated to pay for medical procedures up to your limit.  The insurance company will usually only cover office visits.  All costs of procedures as applied to deductibles will be expected at the time of treatment.  Once your insurance processes your claim, any credits under $25 will be kept in your account and those over $25 will be processed quarterly.

Referrals

Under certain insurance plans, patients are required to have permission from their primary doctor to see a specialist.  If this is the case, we cannot see you unless the referral is in effect and current.  If we do, your insurance company will use this as an excuse not to reimburse us.  It is the responsibility of the patient to make sure their first referral is in effect and ready before their new patient appointment.  If your referral is not ready, we will provide a phone and a number for you to call your primary care physician to have the authorization sent to us by fax.  There may be a delay in your seeing a Derma healthcare provider while this process takes place.  The only other option is to pay for the visit yourself and forego the referral process.

Payment Policy

If your insurance company fails to reimburse Derma within 60 days, you may receive a statement of charges with the expectation that you will follow up with your insurance company.  Being responsible for payment of charges that are denied, non-covered or determined by the insurance company to be patient responsibility whether whole or partial, you may receive statements delineating these.  Outstanding accounts will be placed with a collection agency and will incur an additional $20 late fee/service charge.

Support

With all of these insurance issues, it is easy to become confused and misunderstand charges that may become your responsibility.  The Derma billing staff will do their best to keep you informed and help you with any issues or questions.  Just call us to address any concerns.

Cash Pay Patients

For those who lack insurance, have unmet deductibles, elect to have benign lesions cosmetically removed, or choose to pay out-of-pocket for visits and procedures, full payment is expected at the time of service.  Please understand that these charges shall not be refunded under any circumstances once services are rendered.  Sometimes some people are unhappy with the medical information they receive or are unsatisfied with our recommendations and treatment options, feeling that they then need not pay us for our services.  However, once we have performed our duties for the patient and have provided our expertise and service, we expect full remuneration.  We have to be firm on this issue as some people feel that medical care is a valueless commodity that should be simply granted to them.  Today in the United States, this is definitely not the case.

Cosmetic Moles and Benign Growths

Skin growths that are clinically benign without any significant risk of affecting your health cannot be removed or destroyed and be simultaneously billed under insurance coverage.  This is considered fraud.  Such benign lesions can only be removed with payment by the patient.  This issue usually involves benign normal moles, seborrheic keratoses, wisdom spots, freckles, and skin tags.

Skin Surgery and Plastic Surgeons

Here at Derma we perform many operations on the skin to remove skin cancers, atypical moles, and benign cosmetic growths.  We pride ourselves as being experts of the skin and perform our procedures with an emphasis on cosmetic outcome.  In reality, dermatologic surgeons produce the same scars as plastic surgeons.  No one can cut into skin and have it magically heal without some sort of scar.  We always discuss scar potential with any procedure and wish to educate you on this issue.  If, however, a plastic surgeon is requested to have a role in your care, we will be happy to accommodate you.

Scheduling Appointments:  Your Time, Our Time

Please be on time for your appointment.  New patients are asked to be present 10 minutes prior to their appointment time to complete their registration papers.  If you are more than 15 minutes late, you may lose your position in the patient sequence, having to wait anywhere from 15 – 60 minutes to be worked back in.  Our providers do their best not to be more than 30 minutes late in seeing those who are on time for their appointments.  Unfortunately, with varied medical issues, emergencies, and tardy patients, we cannot guarantee that you will not wait more than 30 minutes.  We do realize this seems one sided and appreciate your understanding.

Cancellations and Courtesy

If you need to cancel an appointment, please kindly give us 24 hours notice.  We have many people who are waiting to be seen and who would love to take your appointment time.  If you do not give us notice or are a no show, a 39 dollar fee will apply.  This must be paid before further appointments can be made.

Balances

No appointments or services will be rendered at Derma and Aura Skin &  Laser unless all outstanding balances for both Derma and Aura Skin & Laser for an account are paid in full. This applies regardless of whether the balance is of a medical or cosmetic nature.

Telephone services

Our medical assistants are trained in taking care of any phone queries you may have concerning your medical care.  They are responsible for relaying information between our healthcare providers and our patients.  They manage the majority of our clinically oriented phone calls, leaving time for our healthcare providers to do what they do best–seeing patients.  If you insist on speaking to a healthcare provider directly for an otherwise routine dermatologic issue or concern, there will be a 39 dollar phone consultation fee.

Pharmacy Refills

Requests for pharmacy refills will not be provided for patients who do not keep their follow-up appointments.  Patients who are on long term therapies may need an appointment for a checkup at least annually.

Medication Authorizations

We do not do any prior authorizations for medications if required by your insurance company. With so may different insurance formulary plans it is difficult for us to obtain prior authorizations. You may pay for a medication out-of-pocket or request a new one.

Paperwork and Forms

Copies of charts will be sent to other physicians free of charge.  For patients who need copies of their charts for their own personal use or who want other paperwork completed by our staff, there may be a minimum of a 9 dollar paperwork processing fee.  This fee may be higher for more involved paperwork requested for legal offices, insurance companies, and employment companies.

Teens and Kids

All patients who are under 18 years of age must be accompanied by a parent or guardian to be seen by a Derma healthcare provider.  If you wish to have your teen or youth be seen by themselves, you may sign a permission form granting us the authorization to examine, evaluate, and treat them without your being there.  If this is done, realize that we will not review or recap what transpired during the appointment over the phone for your convenience.  This will require a phone consultation fee.  Also, major treatment decisions or significant changes in therapies may be deferred until another appointment when a parent or guardian can be present to fully appreciate the ramifications of such.

Our Staff, Our Team

Please realize that every member of our staff is an integral member of the Derma and Aura Skin & Laser team.  Dr. Kwon personally selects all employees and feels they are a reflection of himself and the spirit that is Derma.  They are here to provide for you, to the best of their abilities.  So please, do not dismiss them as extraneous but see them as the dedicated people who make it possible for Dr. Kwon and the other providers to help you. Our office is a teaching facility for healthcare graduate programs in the valley.  A student may accompany your healthcare provider during your visit.

Our Rights

We reserve the right to refuse service to anyone.  We usually only exercise this right in cases of unusually demanding people or those who treat our staff poorly with rudeness.  In some cases we may even ban people from ever coming to our office again.  We can refer anyone to another dermatology office where they may be happier.  Providing dermatologic healthcare service is our profession, not our obligation.

Privacy

We do our best to protect your privacy and medical information.  Please refer to our Notice of Privacy Policies for more information.

The End

Thank you for reading our Patient Handbook!  Your cooperation is appreciated and we hope that this literature helps us to build a long relationship with you!