Q: Will my insurance plan cover a preventative skin exam?
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.
Q: Do I need a referral for an appointment at your office?
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.
Q: Why am I being asked to pay $100-$250 as a New Patient to May River Dermatology?
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.
Q: What is a deductible?
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.).
Q: When will I get my bill?
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.
Q: What are the adjustments on my bill?
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”.
Q: Why did I receive multiple statements for the same visit?
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.
Q: Why does it look like you billed duplicate charges?
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
Q: What will I be charged for MOHS?
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:
NOTE: The above cost range is for MOHS only. It does NOT include fees for:
If you have a high deductible insurance plan, we will ask for $500 at time of service that will go towards your deductible.
Q: What will I be charged for surgical excisions?
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.
Q: Who do I contact if I have a billing question?
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 firstname.lastname@example.org
Q: What options do you have to pay my bill?
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: https://pay.instamed.com/mayriver
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.
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.