Fees, Payment & Insurance

Fees, Payment & Insurance

Commercial Insurance

Dr. Goldwasser does not participate with commercial insurance plans, but if you have coverage through a major insurance company, our office staff will submit your claim for you.

 

Some patients may have out-of-network coverage, and/or a healthcare savings account (HSA) to defray out-of-pocket costs.  Please check with your insurer or your human resources department to understand how these benefits may apply to you.  We will supply you with the necessary paperwork to utilize your HSA upon request.

 

 

Dr. Goldwasser is a non-accepting Medicare provider.  This means that Medicare patients will be asked to pay at the time of service, and the office will submit a claim on their behalf so that they can be reimbursed.  Fees for Medicare patients are limited by law and are lower than our standard fees. 

If you have straight Medicare, with or without a Medigap plan, this applies to you.  There is automatic crossover of claims from Medicare to most Medigap insurance providers.  If you are an established patient of Dr. Goldwasser undergoing a full body skin exam, you will likely be asked to pay a fee of about $140 at the time of service, and you will likely be reimbursed my Medicare and your secondary insurance at about 66%-100%, depending on your plan, and assuming you have satisfied your annual deductible.

 

If you have a Medicare advantage plan, please refer to the paragraph on commercial insurance.  Our office is not participating in these plans. You are not covered by Medicare.

 

The following explanation is from the AARP website:

A doctor who accepts assignment has agreed to accept the Medicare-approved amount as full payment for any covered service provided to a Medicare patient. The doctor sends the whole bill to Medicare. Medicare pays the 80 percent of the cost that it has decided is appropriate for the service, and you are responsible for the remaining 20 percent.

A doctor who doesn’t accept assignment can charge up to 15 percent above the Medicare-approved amount for a service. You are responsible for the additional charge, on top of your regular 20 percent share of the cost. If you have Medigap insurance, all policies cover Part B’s 20 percent copays in full or in part. Two policies (F and G) cover excess charges from doctors who don’t accept assignment.

Fees and Payment:

Dr. Goldwasser is committed to setting fair fees and to fee transparency.  Visit fees and procedure fees will be itemized on your bill, and payment will be requested at the time of service for all patients, in the form of cash, check, or credit card. 

 

Cosmetic and non-covered procedures and fees:

 

Some skin procedures are considered to be cosmetic, i.e. not medically necessary.  Neither insurance companies nor Medicare will cover these.  Medicare patients must sign a form (advance beneficiary notice) to acknowledge this, if they choose to have such a service. These include, but are not limited to, removal of skin tags, seborrheic keratoses, enlarged oil glands, milial cysts, telangiectasia (visible veins), spider veins of the legs, pilar cysts, epidermal cysts, and angiomata.  Dr. Goldwasser will inform you before performing a procedure generally deemed "cosmetic".

Medicare