Financial Policy

Alta Dermatology building

Alta Dermatology Financial Policy

  • FIRST VISIT

    • To allow ample time to check in and complete the initial paperwork, please arrive at least 15 minutes prior to your scheduled appointment. Many of the practice’s forms are available on the portal for you to fill out at your leisure prior to your appointment.

  • PAYMENT AT TIME OF SERVICE

    • Payment is due in full at the time of service. For your convenience, we accept cash, all major credit and debit cards and personal checks. You will be charged a $50 service fee for any returned checks, no exceptions.

  • INSURANCE

    • Patients will be asked to present their insurance card to the receptionist for copying upon check-in at the office each time they are seen for medical services. Please make it a point to bring your insurance card with you each time you visit our office.

    • For those patients covered by insurance plans with which we ARE participating providers, all co-payments, deductibles, and noncovered services are due at the time of service. We will file your insurance claim with the insurance company. If you are covered by a plan that we contract with as a participating provider we will file all claims to your insurance carrier for all covered services. Due to the large number of insurance plans and policies, we only file selected secondary insurances. We encourage our Medicare patients to contact their supplemental insurances to set up coordination of benefits (“auto crossover”) as we do not file for all Medicare supplemental insurances. Medical facilities may bill you directly for lab and pathology services.

    • In the event that your insurance coverage changes to a plan with which we ARE NOT participating providers, we will require payment in full at the time of service and we will file your claim to the insurance company as a courtesy. Any charges that are not paid by your insurance company are your responsibility. Your insurance policy is a contract between YOU and your insurance company. Any referrals, pre-certifications of procedures or testing are your responsibility. Please let us know in advance if your insurance company requires this.

  • CREDIT CARD ON FILE

    • It is the policy of this practice to allow patients to maintain an active credit or debit card on file to ensure prompt payment for the services rendered by this office and for the convenience of the patient. You will be asked for a debit or credit card at the time you check in. The credit card must be in the name of the patient or the patient's authorized representative. Please refer to our Credit Card on File Policy for further details.

  • COLLECTIONS

    • For amounts due after insurance has processed the claim, Alta Dermatology Group will only send 2 consecutive statements at 30 day intervals, and the balance is due in full during that period. Please note, if payment is not received from either you or your insurance company within 60 days from the date of service(s), your account will be considered delinquent and subject to referral to an outside collection agency.

  • MINORS

    • The parent or guardian accompanying the patient is responsible for all charges. All co-pay amounts, deductibles and coinsurances will be due at the time of service. For established unaccompanied minors, non–emergency treatment will be denied unless written consent is provided by the parent or guardian.

  • COSMETIC SERVICES AND PRODUCTS

    • Payment is expected in full at the time of services. We accept cash and all major credit and debit cards. We do NOT accept checks or Health Savings Account (HSA) cards. A non-refundable deposit is required when scheduling select cosmetic appointments. This fee will be applied to cosmetic charges when services are rendered. Deposit will not be refunded if the appointment is canceled or rescheduled with less than 24 hour notice.

  • COSMETIC REFUNDS/RETURNS

    • All services are final sale. We do not offer refunds on services rendered, even if you are disappointed with the result or outcome. We do not offer cash refunds on purchased products. Products may be returned for in-store credit within 14 days from the date of purchase with a receipt when there is a documented allergic reaction to the product. Defective products (e.g. a broken cap) may be exchanged within 14 days of purchase for the same product only, with a receipt. In accordance with federal law, we do not offer refunds or exchanges on prescription products for any reason.

    • Series of Treatments

      • Unfortunately, we are unable to process returns or reimburse any payment transaction on any treatment series that are purchased. We will, however, exchange them for other products or credit of equal value. Remaining pro-rated balances will not include the price of promotional treatments in the package. All packages and pre-paid treatments must be used within 1 year of purchase or they will expire.

    • Revisional Treatment or Treatment of Complications

      • The practice of medicine and medical aesthetics is not an exact science. Although good results are anticipated, there can be no guarantee, expressed or implied, by anyone as to the actual results you may achieve. We will always strive to achieve the absolute best result that we can for you. Occasionally additional treatments and/or treatment for problems or complications may be required. These could result in additional charges for which you may be responsible. Your insurance, if you have it, may or may not cover the expenses related to actual complications or other medically-related problems arising out of your treatment.

    • Full Informed Disclosure

      • Our policy is for you to love the results you achieve. At every consultation and prior to each treatment, we always endeavor to ensure that you understand the full risks, benefits and alternatives associated with each treatment. Please be assured that our team will only recommend treatments and products that will benefit you specifically and which are medically appropriate for you. If you have any questions at any time, please ask as we are here to help you.

  • RELEASE OF INFORMATION

    • I certify that the information given by me in applying for Insurance and/or Medicare payment is true and correct. I authorize Alta Dermatology to act as my agent in helping me obtain payment of my Insurance and/or Medicare benefits, and I authorize payment of these benefits to my Provider on my behalf for any services and materials furnished. I authorize any holder of medical information about me to release to the Health Care Financing Administration and its agents any information needed to determine these benefits payable to related services. If I have other health insurance coverage (as indicated in Item 9 of the HCFA-1500 claim form or electronically submitted claim), my signature authorizes the release of the above medical information to the insurer of the agency shown and authorizes Alta Dermatology to act as my agent, as above.

  • PRIVACY POLICY

    • We respect your privacy and are committed to protecting and securely managing all of the personal information you choose to share with us. During your online visit, you may be required to share personally identifiable information, such as your first and last name, physical address, telephone number, and/or email address. We collect this information in order to facilitate the delivery of services and/or completion of an order. We will never sell, share, or rent your personally identifiable information to third parties in ways different from what is disclosed in the privacy policies.