ARE YOU COVERED BY MY INSURANCE?
We have contracts with the following insurance companies. If you don't see your insurance on the list, call us and ask if we're contracted as the list is not comprehensive. We always recommend you call the number on the back of your insurance card to make sure you have coverage under your specific plan before coming to see us.
- Aetna
- Anthem
- Cigna/Greatwest
- Cofinity
- Coventry
- Emerald Health Network
- Healthreach
- Humana
- Medical Mutual of Ohio
- Medicare
- OSU
- Tricare
- United Healthcare
WHAT IS A PHYSICIAN ASSISTANT OR NURSE PRACTITIONER?
Physician Assistants (PA for short) and Nurse Practitioners (NP for short) are mid-level providers. They're able to do most anything doctors can: diagnose & treat conditions, prescribe medication, and perform minor surgical procedures. They are able to work in any specialty and our PAs and NP have had years of training in Dermatology.
WILL INSURANCE CONSIDER MY VISIT PREVENTIVE CARE?
The short answer is no, we do not bill preventive care visits. What qualifies as preventive care is defined by insurance companies and skin care does not currently fall under their definition. Also, the AMA puts out different CPT codes for regular office visits and preventive care visits. Almost all skin exams will be coded and billed as a regular office visit.
Most skin exams are considered problem-oriented, where patients come in for something specific: a new mole with irregular borders, acne or warts that aren't responding to over-the-counter treatments, skin tags that get cut when shaving, or any multitude of other problems. In each circumstance the patient has a chief complaint, or a physically apparent reason for coming in, which means it is not considered preventive care or a wellness visit. When we start talking about "skin cancer screenings" or "full body skin exams" is where things get a little tricky.
The majority of patients who come in for skin cancer screenings or full body skin exams have noticed a new or changing lesion and they say to themselves, "I might as well get everything checked out while I'm at it." This would still fall into a problem-oriented visit because the patients are presenting with a specific illness. Some patients may have a history of skin cancer, so they schedule their skin check and the dermatologist will find and possibly treat some lesions during the visit. This again won't be considered preventive, mostly because a procedure was performed, but also because the patient is symptomatic.
Still other patients may just like their dermatologist and come in to get their skin checked regularly. We think that's great! And we generally recommend at least annual full body skin exams depending on age and medical history; however, insurances don't cover skin cancer screenings as preventive care and it's often inappropriate for us to bill that way.
Visit the U.S. Preventive Services Task Force website for more info on why skin cancer screenings aren't preventive care. Also see a list of preventive services covered by Medicare.
Most skin exams are considered problem-oriented, where patients come in for something specific: a new mole with irregular borders, acne or warts that aren't responding to over-the-counter treatments, skin tags that get cut when shaving, or any multitude of other problems. In each circumstance the patient has a chief complaint, or a physically apparent reason for coming in, which means it is not considered preventive care or a wellness visit. When we start talking about "skin cancer screenings" or "full body skin exams" is where things get a little tricky.
The majority of patients who come in for skin cancer screenings or full body skin exams have noticed a new or changing lesion and they say to themselves, "I might as well get everything checked out while I'm at it." This would still fall into a problem-oriented visit because the patients are presenting with a specific illness. Some patients may have a history of skin cancer, so they schedule their skin check and the dermatologist will find and possibly treat some lesions during the visit. This again won't be considered preventive, mostly because a procedure was performed, but also because the patient is symptomatic.
Still other patients may just like their dermatologist and come in to get their skin checked regularly. We think that's great! And we generally recommend at least annual full body skin exams depending on age and medical history; however, insurances don't cover skin cancer screenings as preventive care and it's often inappropriate for us to bill that way.
Visit the U.S. Preventive Services Task Force website for more info on why skin cancer screenings aren't preventive care. Also see a list of preventive services covered by Medicare.