If we do not have a contract with your medical insurance company, or if you do not have medical insurance, payment in full is expected at the time of your visit.
You will be required to show a copy of your insurance card at each visit. If you do not have your insurance card or we are unable to verify your coverage, payment in full is expected at the time of your visit.
Please be aware that some or all the services that you request, or that your provider feels are necessary, may not be considered medically necessary under Medicare, Medicaid, Blue Cross, or any other medical insurance. Such services would not be paid by any insurance company. Payment in full is expected at the time of your visit. Please ask for a written cost of services estimate before any services are performed.
Medicaid patients must have a current card.
Many insurance carriers require a referral from your Primary Care Physician before you receive care from a specialist. It is your responsibility to obtain a written referral or prior authorization if your medical coverage requires it.
All checks are verified. There is a $30.00 fee for checks with insufficient funds.
Deductibles and co-payments must be collected at the time of your visit. It is not our responsibility to know your deductible status. If you do not know your deductible status, payment in full is expected at the time of your visit.
Office visit charges do not include laboratory tests, injections, biopsies, surgical procedures, medications, and supplies. These services are at additional cost. Please ask for a written cost of services estimate before any services are performed.
Cosmetic services are not covered by insurance and full payment is required in advance of the procedure. Your procedure appointment will not be scheduled until payment is received.
Minor and Incompetent Patients: North Carolina law regarding minor or incompetent patients states that the party seeking or authorizing treatment of such a patient is responsible for paying the bill. Arrangements between any other parties have no force or effect on Polley Clinic of Dermatology and Dermatologic Surgery P.A.
If your account becomes delinquent, you will be held liable to pay all collection company or attorney fees.
Ask for a written cost of services estimate before any services are performed. If you change Primary Care Doctors, new referrals are needed.
Refunds for any reason are issued by the 15th of the next month.
Polley Clinic of Dermatology participates accepts most major insurance providers. However, it is important that you contact your insurance provider before receiving treatment to verify we are In-Network as some of these plans have multiple plan types.
Regardless of insurance coverage, you are responsible for payment of all services performed.
|Blue Cross Blue Shield||Carolina Complete||Cigna|
|First Health||HealthSmart||Healthy Blue|
If you have any billing questions, please call 800-300-7819. We will be happy to help.