Our team of professionals and staff believe that informed patients are better equipped to make decisions regarding their health and well-being. For your personal use, we have created an extensive patient library covering an array of educational topics, which can be found on the side of each page. Browse through these diagnoses and treatments to learn more about topics of interest to you. On this specific page we will also try to answer some of the most common questions we get from our patients regarding office visits, billing and insurances.

As always, you can contact our office with any additional questions or concerns you might have! 

One of the most frequently asked questions we receive is "Can you help me with my statement from the insurance company?"  So let's decipher these complicated statements.

EOB

How Physicians refer to your Explanation of Benefits (the statement from the insurance company regarding your doctor's visit).

Account Number

Your account number represents your number with the doctor that is assigned to you at your first visit.

Claim Number

Every claim is assigned a claim number, if you need to contact your insurance company it's helpful to have this number (will save you some time).

Date of Service

The date you saw your doctor.

Procedure Number

Here is where it gets tricky.  Every office visit is assigned a CPT code or numerical value.  Without giving everyone a billing lesson these generally run from 1 to 5 as in 99243, 99244, 99245 or 99213, 99214, 99215.  You may also see "surgical" codes here.  Whenever a physician treats you in the office whether by freezing, excising, scraping or removing, these codes fall under the "surgical" category.  

Units of Service

For example, if you had multiple Actinic Keratosis treated by liquid nitrogen you may see the first procedure number 17000 (first lesion destruction) and then you might see 17003 (4) units (second through fifth lesion destruction).  We have to code this way it's the law.

Billed Amount

The billed amount is just the amount the physician billed.  It is not the amount your coinsurance or deductible will be based on.  The doctor is required by both federal and state laws and by the contract with the insurance company to write off or adjust any amount over the "allowed amount."

Allowed Amount

This is the amount the insurance company determines the physician should charge for the procedure code.  

Contractual Adjustment Amount

This is the amount the physician must write off on primary insurance ONLY (physicians are not required to write off secondary or tertiary adjustments).

Deductible

The amount that you must pay out of pocket before the insurance company will start to pay your claims.  The physician is still required to write off the contractual adjustment even if you haven't met your deductible. 

Co-Pay

This can be the set amount you must pay at every visit and it can range from $5.00 to 75.00 or more.  This column also includes co-insurance, which represents percentage after the adjustment is made that is your responsibility.  Depending on your contract this can be 10% to 50% of the allowed charges.

Amount Paid

This is the amount that was sent to the doctor on your behalf. Also, notes at the bottom will explain why something was not allowed or why the insurance company is only paying a portion of the allowed charges and not all of them.

Additional Info

There should be a phone number on your explanation of benefits if you have any questions regarding the claim or why it was processed the way it was. Don't be afraid to contact your insurance company, sometimes an insurance company will process a claim "out of network" and the physician is "in network." If this error occurs, it will generally cost you more money.  However, insurance companies will often reprocess the claim if the original claim was processed in error.

It is also worth noting here that you choose your plan and your insurance company and your network.  The physician is not there with you guiding you during this process and that is the way it should be.  However, the physician has limited control over the terms you set with your insurance company - they are contractually prohibited from writing off co-pays or deductibles.  It is against the law for a physician to bill a procedure or office visit in a specific way only so that it may be covered by your insurance company.  They must bill for exactly what happened and when it happened.

The skin is the body's largest organ and accounts for roughly 18% of an adult's weight. It serves as a protective outer layer that keeps in moisture and keeps out invasive organism (like infections). It protects our organs against injury. It also helps regulate the body's temperature and has self-healing capabilities.

The best way to maintain healthy skin is to prevent skin damage from occurring in the first place. Wrinkles, age spots and leathery patches are all the result of skin damage from overexposure to ultraviolet radiation from the sun. But the aging process for skin is unavoidable. As we age, skin becomes dryer and thinner. Repeated movements of facial muscles, such as frowning, smiling or squinting, cause wrinkles over time. Stress, gravity and obesity also contribute to aging skin. And because the skin is thinner, it is more susceptible to bruising.

Photoaging

The premature aging of the skin from ultraviolet light exposure is called photoaging. Photoaging occurs when ultraviolet radiation penetrates deep into the dermis, damaging collagen fibers and causing the increased production of abnormal elastin. This breakdown in fundamental skin structures leads to deep wrinkles, fine lines, discoloration of the skin (age or liver spots), leatheriness and sagging skin.

Skin Care Routine

A healthy skin care routine throughout life can reduce the symptoms of aging in the skin. Be sure to:

  • Wash your face using a gentle cleanser and lukewarm water twice a day.
  • Pat skin dry; don't rub it dry.
  • Exfoliate the skin twice a week to remove dead cells.
  • Apply a moisturizer to skin immediately after a shower or bath.
  • Wear sunscreen with a SPF of at least 15 every day.
  • For women who wear makeup, be sure to leave time each day when the skin is clean and free of makeup.
  • Do not use tanning beds.
  • Maintain a healthy diet and drink lots of water.
  • Get an adequate amount of sleep every day.
  • Quit smoking.
  • Avoid stress.
  • Conduct a monthly self-examination of your skin to detect any changes that might lead to cancer.
  • See your dermatologist once a year.

Anti-Aging Treatments

Beyond prevention, in today's world there is a wide range of options for slowing down the affects of aging on the skin. See the Cosmetic Dermatology section of this website for more information about:

  • Botox
  • Chemical peels
  • Dermabrasion
  • Fillers
  • Laser Resurfacing
  • Retinoids

Skin Infections

Anyone who has a break in the skin is at risk for an infection. There are three types of skin infections:

Bacterial Infection

There are many bacteria that live on the surface of healthy skin. But with a break in the skin, these bacteria can invade the outer layer of skin and cause an infection and rash. Staph is a common cause of bacterial infections of the skin. Impetigo is one of the most common causes of skin infections in children. Oral or topical antibiotics are used to treat bacterial skin infections.

Viral Infection

Viruses are parasitic organisms that can live and grow inside living cells. They cause either a degeneration or a proliferation of the cell. Most causes of viral skin infections are either from Human Papilloma Virus, which causes warts, or Human Herpes Virus, which causes cold sores, chicken pox, shingles, genital herpes and mononucleosis. Viruses do not respond to antibiotics. Generally, medications are prescribed to help alleviate the symptoms of the infection, such as a rash or itch. Additionally, vaccinations are used to prevent viral infections.

Fungal Infections

Fungal infections of the human body are called mycoses and affect only the outer layer of skin. Although seen in all areas of the body, skin mycoses most frequently appear as yeast infections, thrush, athlete's foot or jock itch.