INSURANCES ACCEPTED

The world of insurance is very complicated so we’re going to do our very best to explain how medical visits are treated and covered by insurance companies.

IN-NETWORK VS. OUT-NETWORK

If your provider has been credentialed by an insurance payer AND is approved for your specific plan type then they are considered in-network. For example, Refine Dermatology is credentialed with Blue Cross Blue Shield of TN and approved for plans ‘P’ and ‘S’ so we’re in-network for patients that have that particular insurance payer and plan. But, if a patient were to subscribe to Blue Cross Blue Shield of TN and have a ‘L’ plan than Refine Dermatology would be an out-of-network provider.

If your medical provider is out of network your insurance company may still provide benefits, but this is something to check with them about before your visit so that you’re aware of your financial obligation.

DEDUCTIBLES

If you’d like to use insurance for your visit, first verify that we’re in-network with your insurance provider by checking with them and providing them with Dr Salyards NPI (1972868438). Next, determine how much you’re going to have to pay before your insurance will pay anything towards your bill by asking what about your deductible.

The deductible on your insurance plan is how much you’ll have to pay out of pocket towards medical expenses before your insurance payer will start contributing anything towards your medical bills.

An example is a patient with a $1,000 deductible which hasn’t been met and who sees Dr. Salyards for the first time and the new patient visit is $150. The patient would need to pay the $150 for the visit and their remaining deductible would reduce to $850.

If you’d like to know your deductible before visiting your doctor call your insurance company and ask them directly. Medical practices don’t always have the most up-to-date information.

CO-PAYS

Sometimes plans have co-pays that apply to visits only or to the visit and any procedures performed. The copay limits how much the patient will have to pay, but can become confusing if the patients insurance plan has a deductible. Here’s an example of an insurance plan that has a deductible of $500 and co-pay of $50.

Patient has a full body skin exam and a biopsy performed. They would owe $50 copay for the visit and then if they’re deductible hadn’t been met, they would owe the full amount of the procedure unless it was greater than $500.

OUT OF POCKET MAX

Not all insurance plans have this feature but this removes financial responsibility from patient’s if they exceed this amount in medical bills. For example, a patient has a $50 copay, $500 deductible and $2,000 out of pocket maximum. In their calendar year they’ve met their deductible and also spent $1500 in copays (they’ve spent a total of $2,000). Any visits and procedures would be covered by whatever amount the insurance payer has agreed to cover.

AMOUNT OWED AT TIME OF VISIT

Some doctors office elect to collect co-pays at time of visit. Unfortunately, sometimes information provided by the insurance.