PATIENT PAYMENT RESPONSIBILITY POLICY

Alpha Dermatology of Pennsylvania, LLC has contracted with a number of government and private payors to provide dermatology care. These contracted payors consider Alpha Dermatology of Pennsylvania "in-network," and Alpha Dermatology of Pennsylvania has agreed to the terms set forth by these payors.

This list of payors is updated frequently, and can be found on the alphaderm website. This list is not a guarantee that Alpha Dermatology of PA, LLC is "IN-NETWORK" with all of the plans offered by each carrier on the list.

IT IS THE PATIENT'S RESPONSIBILITY TO VERIFY WITH THEIR INSURANCE PLAN THAT ALPHA DERMATOLOGY IS "IN-NETWORK" FOR THE PATIENT'S SPECIFIC HEALTH INSURANCE PLAN.

It is also the responsibility of the patient to know which procedures and treatments are covered by their health insurance plan prior to electing treatment. The procedure and treatment codes are available upon request prior to treatment.

IT IS THE PATIENT'S RESPONSIBILITY TO IDENTIFY THE PATHOLOGY LABORATORY (i.e. QUEST DIAGNOSTICS or LABCORP) THAT IS "IN-NETWORK" FOR THE PATIENT'S HEALTH INSURANCE PLAN. UPON PATIENT REQUEST, WE WILL SEND PATHOLOGY TO THE REQUESTED PATHOLOGY LAB. ALPHA DERMATOLOGY IS NOT RESPONSIBLE FOR CHARGES THAT OCCUR WHEN A PATIENT FAILS TO DIRECT THE SPECIMEN TO THE "IN-NETWORK" PATHOLOGY LABORATORY.

Pathology services are provided by third party vendors - not Alpha Dermatology of Pennsylvania. You have the right to designate which pathology laboratory you want to use, as long as the standard of medical care is maintained in the opinion of your provider.

Patients of Alpha Dermatology of Pennsylvania with either no insurance coverage, or insurance coverage that considers Alpha Dermatology of Pennsylvania "out of network," will be responsible for paying the entire cost of treatment based on the non-negotiated fee schedule. The non-negotiated fee schedule is available by request prior to treatment.

Patients are expected to pay the entire balance due as reflected on the explanation of benefit (EOB) analysis that is generated by their insurance company once the claim has been processed.