Patient Forms and Insurance Info

New Patient Packet

Accepted Insurance


All MD’s and PA’s/NP’s at May River Dermatology are currently a participant in the following insurance plans in South Carolina:

  • Aetna
  • Blue Cross Blue Shield (Preferred, State & Federal, Medicare Advantage)
  • Cigna
  • First Health
  • Humana
  • Medicare
  • MultiPlan / PHCS
  • Tricare
  • United Healthcare
If you do not see your insurance listed please call our office (843) 837-4400 and choose option 4

Johns Creek

  • Aetna
  • Anthem BCBS (Preferred, State & Federal, Medicare Advantage)
  • Cigna
  • First Health
  • Humana
  • Medicare
  • MultiPlan / PHCS
  • Tricare
  • United Healthcare

If you do not see your insurance listed please call our Johns Creek office (470) 282-5729

Securely Send and Upload Information

Click below to send files directly to the practice via a secure and HIPAA compliant interface

Send Files

Returning Patients

Click below to go to our secure patient portal where you can view your past visit information, make appointments, send questions to our staff, and update your information. You will need your User ID and Password assigned during your first visit to access the patient portal. Please call our office if you need assistance.

Patient Portal

Common Billing FAQs

Our providers are happy to see you for an exam and consultation. Insurances do not cover preventative skin examinations. Once a condition or lesion has been diagnosed by a dermatologist (whether the spot is benign or malignant) – it is not considered preventative care.  All skin exams will be coded and billed as a regular office visit.

Referrals are only required in our office if specified by your insurance company. Please contact your individual plan to determine if your plan requires a primary care referral for a specialist office.

This is our new patient policy; if you have a high deductible plan, dependent on what treatment is done in the office at time of service. We will file to your insurance and will either send you a statement for the difference owed or issue a refund via check or credit card.

An annual deductible is the dollar amount you must pay out of pocket during the year for medical expenses before your insurance coverage begins to pay. There are times when you may be asked to pay towards your deductible at time of service (i.e.. Surgical procedures, MOHS, New Patient appointments, etc.).

After your visit, we will file to your insurance. Statements are sent after your insurance processed all of the charges. If there is no balance due from you, you will not receive any notice.

We are in network with a variety of insurance companies and as a benefit of being covered by that insurance you get a discount “adjustment”.

Depending on the services rendered, the claims may be sent to your insurance at different times. For example, pathology charges are sent out separately to office visits and procedures. Other situations that can affect this are: claim denials, inaccurate insurance information, etc. If insurance denies any of your services, our billers work with your plan to attempt to get the claim paid. This can result in some charges being billed out before others.

Pathology charges can look like duplicate charges; however, they have a special indicator on the end called a modifier, -26 and -TC. You will almost always have two pathology charges, one for each component. The charge with a -26 on the end is the professional component, which means your specimen was viewed and interpreted by our dermatopathologist. The -TC component is the technical component, which represents the cost of lab equipment and supplies used to process your specimen.

The lab that you may receive a bill from is:

Polaris Skin Diagnostics

8170 Rourk Street, Ste 100

Myrtle Beach, SC 29572

Mohs can range from $1000-$3000. The procedure consists of two parts – the removal of the skin cancer and the repair of the wound.

The price of MOHS is determined by the following:

  • The number of stages it will take for the cancer to be completely removed
  • The type of repair needed in order to close the wound

NOTE: The above cost range is for MOHS only. It does NOT include fees for:

  • Any additional procedures/pathology (example: biopsy of a different site)
  • Any follow up care

If you have a high deductible insurance plan, we will ask for $500 at time of service that will go towards your deductible.

Surgical excisions can range from $350-$600. There will also be a separate pathology bill as we send out tissue to ensure margins are clear of any skin cancer.

If you have a high deductible insurance plan, we will ask for $300 at time of service that will go towards your deductible.

We are here to help with any questions, Monday-Friday from 8am-5pm. Please call (843) 837-4400 and select option “4” at the prompt to reach the billing department or you can email

We accept all major credit cards. You may call our billing department who can take your credit card information over the phone and process your payment. You may also make a payment online at: Healow Pay

The Surprise Billing Act

The Department of Health and Human Services has mandated that self pay patients and patients with non-participating (out-of-network) insurance plans must be given a notice of non-participating status, consent for treatment, and good-faith estimate of costs by the healthcare facility or provider. These documents must be provided 72 hours in advance of scheduled services. When services are scheduled less than 72 hours in advance, these documents must be provided at least 3 hours prior to the scheduled services.

Emergency services are exempt from the good-faith estimate requirement, since such services are not scheduled in advance.

Balance Billing 

Notice, consent, and good-faith estimates must be obtained from the participant, beneficiary, or enrollee. An authorized representative, as defined by state law, may receive notice, consent, and estimate on behalf of the participant, beneficiary, or enrollee. Once obtained, these documents must be retained by the facility or provider for a period of at least 7-years from the date of service.

If notice, consent, and estimate are not obtained in accordance with the Surprise Billing Act, the non-participating healthcare facility or provider must not bill, and must not hold liable, the participant, beneficiary, or enrollee.


If a patient feels that a non-participating facility or provider has violated any provision of the Surprise Billing Act, they may file a dispute with the Department of Health and Human Services. This includes if the healthcare facility or provider bills in excess of the good faith estimate.

The dispute resolution process must start within 120 calendar days (about 4 months) of the date on the original bill. If the agency agrees with the patient, the patient will pay the amount on the good faith estimate. If the agency agrees with the healthcare facility or provider, the patient will pay the higher fee shown on the bill. There is a $25 fee to use the dispute process.

To learn more or obtain a form to start the dispute process, call 1-877-696-6775 or visit the DHHS website.