Surgery Cancellation Policy
Carlisle Dermatology Group is privileged to provide treatment for our patients. Our goal is to provide and maintain a good physician-patient relationship. Letting you know in advance of our office policy allows for a good flow of communication and enables us to achieve our goal. Our staff accommodates the needs of patients to schedule surgery in a timely manner. This requires careful planning and coordination among our office and other medical specialists who may be involved in your care. The cancellation of a scheduled surgery results in failure to serve other patients as well as disruption in schedules for other healthcare professionals. Therefore, we respectfully request your cooperation and understanding of the surgery scheduling process and our cancellation policy.
PLEASE read each section carefully.
If you are not able to keep an appointment, we require 10 business days’ notice.
For cancellations, including rescheduling or a missed appointment of Mohs surgical procedures made within 10 business days of the scheduled date will be assessed a $200.00 fee.
For cancellations, including rescheduling or a missed appointment of superficial excisional surgical procedures made within 10 business days of the scheduled date will be assessed a $100.00 fee.
If you are a NO SHOW for 2 surgical appointments, you will be dismissed from the practice.
1) It is your responsibility to keep us updated with your correct insurance information. If the insurance company you designate is incorrect, you will be responsible for payment of the visit and to submit the charges to the correct plan for reimbursement.
2) It is your responsibility to understand your benefit plan regarding covered services and participating laboratories. Please advise our staff if you prefer a particular laboratory to process your specimen or culture.
3) It is your responsibility to know if a written referral or authorization is required to see specialists, whether preauthorization is required prior to a procedure, and what services are covered.
1) Pending your insurance carrier benefit plan, we may require a surgery deposit of $300.00 minimum for Mohs surgical procedure and $150.00 for superficial excisional surgical procedure. If this is required, you will receive a call from our office prior to your procedure.
2) You are responsible for any and all co-payments, deductibles, and coinsurances as applicable for your procedure.
3) Co-payments are due prior to seeing the provider. If you are unable to furnish your co-pay, you must notify Carlisle Dermatology Group and reschedule your appointment in a timely manner.
4) Self-pay patients are expected to pay for services in full at the time of the visit.
5) If we do not participate within your insurance plan, payment in full is expected from you at the time of your visit. We will coordinate with our billing company and supply you with an invoice that you can submit to your insurance for reimbursement.
6) Patient balances are billed immediately on receipt of your insurance plan’s explanation of benefits.
7) If previous arrangements have not been made with our billing company, any balance outstanding longer than 120 days will be forwarded to our collection agency.
8) A $30 fee will be charged for any checks returned for insufficient funds.
Please contact our office at 717-701-8251 with any questions.