Our Financial Policy

Atrium Dermatology^® has contracted with many insurance companies, both in and out of Ohio.  Each company has its own set of approved fees that we apply when billing our services. Even if your insurance allows a higher amount than our standard fee, we will not bill you any amount above that agreed fee for that date of service. 

Many insurance companies require a co-payment, deductible and co-insurance to be paid by you.  Our statements reflect these amounts, and must be paid upon receipt. In the event you feel that your statement is incorrect please call us as soon as possible so that we can make any necessary adjustment.  We will bill your insurance carriers before billing you.  In the event there is a balance due, we will send you a statement. Payments made by you will generally first be applied to the oldest outstanding balance. All checks should be made out to Esti Gumpertz, M.D.

Patient Responsibility:

While you are personally responsible for the cost of all services we provide even though you have insurance coverage, we will, as a courtesy, bill your insurance carriers before billing you. Remember that you are the beneficiary under your insurance agreement, and that we are the third party provider.  Disputes over coverage must be resolved by you. If your insurance will not honor your policy or recognize a charge, we may bill you directly.

Under all our contracts with insurance companies the insurance carrier has agreed to pay us directly.  If your insurance pays you, please contact us immediately so that we can appropriately adjust your account.

It is very important that you give us current information regarding your insurance coverage, and that at all times your address and phone number are current.  Let us know promptly if you have moved, or if you have a new phone number. You might also want to revisit your emergency contact information periodically so that we can reach him or her if necessary.

Co-Payments:

A co-pay is the amount your insurance company requires you to pay each time you see the doctor. To avoid a $5.00 surcharge, the co-pay must be paid in full at each visit when you arrive to see the doctor.  The exact amount is usually printed on the back of your insurance card.    

Annual Deductibles:

In addition to the co-pay, some plans have an annual deductible. The annual deductible is the amount you have to pay out-of-pocket before your insurance will pay us for our services. Only after you have paid this amount will your insurance start to pay its contractual share of our charges. However, even before your insurance makes any payment because of the annual deductible, our charge to you will never be higher than the amount we have negotiated with them.  We will write off the difference, and bill you only for the balance.

Co-Insurance:

Most insurance plans require you to pay a percentage of the cost of services.  This amount, commonly referred to as co-insurance, must be paid by you in addition to any co-pay. Since we usually only know how much co-insurance is due after your insurance has considered a claim, you will only be billed co-insurance amounts after we have received an explanation of benefits from your insurance.

Referrals:   

If your insurance requires a referral from your primary care physician, you must have one before Dr. Gumpertz can see you. It is your responsibility to make sure that you have the referral. If you choose, in the absence of a valid referral you can self-pay for the visit. The amount you pay will be credited to your account balance if your insurance subsequently pays for the service.

Secondary Insurance:

Many of our patients have coverage under more than one insurance policy.  It is important that you let us know which company is primary, and which secondary.  As a courtesy, we will usually bill both carriers on your behalf.  If you have primary coverage under Medicare, make sure that Medicare is aware that they are your primary carrier or they may not pay for your visit!   You should do this by calling Medicare’s co-ordination of benefits department, toll free, at 1 (800) 999-1118.  Also, be sure to let us know if you have elected to receive Medicare coverage under a "Medicare Advantage Plan".  These plans have different billing rules and account numbers, and will often require a co-pay at time of service.

If you have any questions about your bill, or need to update your billing address, insurance carrier information or payment preferences, call us at (440) 646-1600. We will do our best to explain any discrepancies and to clear up any misunderstandings or errors at this time. Prompt action on your part allows us to serve you more efficiently and avoids our having to add billing and collection fees to your account.

Atrium Dermatology^® Expert skin care you can trust

We proudly service Cuyahoga, Lake and Geauga counties.

Call us at (440) 646-1600

or send us an email at AtriumDerm@aol.com

For a map and directions, click here.