2025 Office Policy and Financial Consent

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Welcome to Lincoln Road Dermatology
Thank you for trusting us with your dermatologic care. To ensure a seamless and positive experience, we kindly ask you to review the following policies. These guidelines are designed to keep communication clear and ensure your care is as smooth and stress-free as possible.

 

Credit Card on File Requirement
Our office requires a valid credit card on file (CCOF) for all patients. This ensures timely payment for balances, including copays, deductibles, coinsurance, cosmetic or elective services, and any denied insurance claims. A valid CCOF helps us minimize the need for extensive follow-up or collections. If your CCOF is declined, we kindly ask you to promptly update it or pay the outstanding balance in full. Failure to do so may result in your account being sent to collections.

Please bring your insurance card, ID, and a valid form of payment to every appointment. Kindly note that we do not accept checks.

 

Small Lobby Courtesy
To maintain a comfortable environment for all patients, we kindly ask that you avoid bringing skateboards, bikes, scooters, or other large items into the office. Our lobby space is limited, and we want to ensure a safe and welcoming atmosphere for everyone.

 

Kindness and Respect Policy
At Lincoln Road Dermatology, we are committed to fostering an environment of mutual respect and professionalism. While we are dedicated to providing compassionate care, we maintain a zero-tolerance policy for rudeness or disrespectful behavior toward our staff or other patients. We kindly ask that all interactions remain courteous to ensure a positive and welcoming experience for everyone.

 

Visit Types and Payment Policies

1. Insurance-Based Visits
   For patients using insurance, it is your responsibility to understand your plan, verify if our office is in-network, and be aware of any associated costs.

2. Self-Pay Visits
   For self-pay patients, we offer clear and upfront pricing for all services to ensure transparency. Our pratice offers a self-pay discounted rate of $200 for patients who choose to pay out of pocket at the time of service. Self Pay consultations are charged $200.  Any procedures or lab costs will be discussed prior to performing such services.

3. Cosmetic or Elective Services
   Cosmetic or elective services are not covered by insurance and require full payment on the date of service. For additional information, please see the Cosmetic or Elective Services section.

 

Insurance-Based Patients

Know Your Plan
It is your responsibility to understand your insurance plan, verify whether Lincoln Road Dermatology is in-network, and be aware of any exclusions, deductibles, or out-of-pocket costs. By seeking care at our office, you accept the terms of your insurance plan and acknowledge that any costs not covered by insurance are your responsibility.

Insurance Verification
Lincoln Road Dermatology (LRD) uses an insurance verification system to confirm coverage. While we strive for accuracy, this system is not infallible, and we cannot be held responsible for incorrect details. However, we are committed to working with you to resolve any outstanding balances in accordance with our policies and your insurance guidelines, striving for a fair resolution for all parties.

Insurance Payment Delays and Denials
If your insurance requires verification of additional coverage or coordination between primary and secondary insurers (commonly referred to as "stalls"), this may delay payment to our office. You are responsible for promptly addressing these issues with your insurance provider. If payment or resolution is not received within two weeks of notifying you, we will collect up to $225 from the card on file to cover the consultative portion of the visit. This ensures our office is compensated while allowing you additional time to resolve the delay with your insurance provider.

If your insurance denies coverage for your visit, we will collect up to $225 from the card on file for the consultative portion of the visit. You will then need to work directly with your insurance provider to resolve the denial. Any reimbursement received by our office to satisfy the previously denied claim will be applied to your account or refunded to your original payment method, ensuring fairness and maintaining our financial integrity.

 

Lab Fees and Procedures
Most laboratory services, such as processing skin samples, swabs, or blood work, are performed by an independent lab. Charges for these services, including pathology, are separate from any fees for our office services. If you have insurance, the lab will bill you directly according to your insurance policy.

For self-pay patients, we will provide upfront pricing, charge you directly, and pass the payment to the lab, as the lab will bill our office.

Our office provides two in-office lab tests: urine pregnancy tests and streptococcal throat swabs. These tests are billed directly by our office.

Charges for procedures performed in our office, such as biopsies, excisions, and cryotherapy, are also billed separately from consultation fees and remain your responsibility.

 

Cosmetic or Elective Services
Cosmetic consultations and services are separate from insurance-based medical visits and are not covered by insurance. Payment is required in full on the date of service. A cosmetic consultation fee applies for all cosmetic concerns. While extensive cosmetic concerns are typically not addressed during a medical visit, we may be able to accommodate a brief consultation if time permits, with the applicable fee. For the best experience and to ensure adequate time for your concerns, we recommend scheduling a dedicated appointment for cosmetic services.

 

Payment Policies
Payment for anticipated copays, deductibles, coinsurance, cosmetic or elective procedures, self-pay services, and items purchased in the office is required at the time of your visit. A valid credit card on file (CCOF) ensures timely payment for balances, including copays, deductibles, and denied claims. HSA or FSA cards should not be used as the CCOF, as they may not cover all charges.

After your insurance processes a claim, you will receive a text invoice from LRD detailing your financial responsibility. This text invoice provides information about the balance determined by your insurance provider after they have processed and adjudicated the claim. If unpaid after the first notification, a second and final reminder will be sent. Shortly thereafter, the balance will be charged to the credit card on file.

 

Certified Letter and Collection Fees
A fee for certified letters sent due to unanswered follow-up or treatment-related communications will be added to your account. Accounts sent to collections will incur additional fees, including attorney or agency costs, and a 30% service charge will be applied to outstanding balances.

 

Refund Policy
Refunds for overpayments or insurance adjustments will be issued to the original payment method whenever possible. If a refund cannot be processed to the original payment method, the amount will remain on your account as a credit for future services. Processing times vary based on insurance.

 

Missed Appointments
When you schedule an appointment, time is reserved specifically for you. Missed appointments or late cancellations disrupt our ability to care for other patients. A missed appointment is defined as failing to show up for a scheduled visit or failing to provide at least 24 hours’ notice to cancel or reschedule.

Missed appointment fees are $50 for medical visits and $75 for surgical, cosmetic, or aesthetic visits. If your first appointment is missed, you must pay the missed appointment fee before rescheduling, plus an additional $50 deposit to secure your next appointment. This deposit will be applied to the cost of your visit and safeguards against another missed appointment. Repeated no-shows or late cancellations may result in dismissal from the practice.

 

Procedures, Risks, and Lab Charges
If recommended and agreed upon, I consent to procedures such as biopsies, cultures, surgeries, injections, or cryotherapy. I acknowledge that these procedures include inherent risks, such as pain, bruising, bleeding, scarring, skin color changes, infection, recurrence, or further care. These procedures are billed separately from consultation or follow-up visits.

 

Medical Photography
I consent to medical photographs being taken for my records and shared securely with third-party providers as necessary for care.

 

Telemedicine Policy
If I willingly participate in a telemedicine visit, I consent to the use of telemedicine services and acknowledge their limitations. I understand that if my insurance denies coverage for the visit, I will be responsible for a $225 fee.

 

HIPAA Compliance and Communication
I acknowledge that I have been informed of Lincoln Road Dermatology’s Notice of Privacy Practices and Florida Patient Bill of Rights, accessible online at https://www.lincolnderm.com/patient-resources. I understand that these documents are available to me upon request. I consent to receive communication from Lincoln Road Dermatology via phone, text, or email regarding appointments, billing, and medical results. This consent will remain valid until I revoke it in writing.

 

Acknowledgment and Consent
By signing below, I confirm that I have read, understood, and agree to the policies outlined above. If the patient is a minor or unable to consent, I affirm that I am the legal guardian or authorized representative.