Your first visit to the Dermatologic Center for Excellence establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You’ll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There’s also background information about our first visit procedures. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.
Please note: Due to the increase in no shows and same day cancellation of appointments, all New Patients are required to pay a $50 deposit to book an appointment, which will be applied to their visit upon completion. If you fail to show for your appointment, or cancel without our required 24 hours notice, the deposit will be applied to the associated fee. You may click the link below to pay this deposit online.
At the Dermatologic Center for Excellence, it is our mission to provide a full range of medical and surgical dermatological services to help patient’s look and feel their best. Through our superb clinical providers, expertly trained Physician Assistants and friendly administrative staff, we provide the most advanced technologies to benefit our patients within the environment of a state-of-the-art dermatology office. Through our professional, compassionate, and caring staff members, our goal is to ensure every treatment is customized to meet each individual patient's needs for skin treatments. For information about your skin condition and available treatment options, call the Dermatologic Center for Excellence at 1-716-636-DERM .
Thank you for the opportunity to serve you. We look forward to developing a long and successful relationship with all our patients and having you feel confident that you are receiving the best possible care.
Please print and fill out these forms so we can expedite your first visit:
- Patient Registration & Intake
- HIPAA Form
- Financial Policy
- Credit Card Authorization Form (see below for further explanation/FAQs)
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctor. We look forward to your first visit.
Frequently Asked Questions Regarding the Credit Card on File Agreement
Do I have to leave my credit card information to be a patient at this practice?
Yes. This is our policy and it is a growing trend in the healthcare industry. Insurance reimbursements are declining and there has been a large increase in patient deductibles. These factors are driving offices to either squeeze more patients into shorter periods of time or to stop accepting insurance. We have decided to focus on becoming more efficient in our billing and collections processes instead.
How much and when will money be taken from my account?
The insurance companies on average take approximately 2-4 weeks to process submitted claims. Whatever the allowed amount is, your copay, coinsurance, and deductible are taken into consideration. It simply depends on your individual policy what you may owe. Once the insurance explanation of benefits is received and posted to your account, you will be sent a statement showing your portion. You will have 30 days to send an alternative form of payment if you prefer. If no alternative payment is received, your patient financial responsibility will be processed. Please Note: If your card is denied, a $10 late fee will be added each month following, until the balance is paid, as noted in our financial policy.
How do you safeguard the credit information you keep on file?
We use the same methods to guard your credit card information as we do for your medical information. The card information is securely protected by the credit card processing component of our HIPAA compliant practice management system and credit card manager. This system stores the card information for future transactions using the same sort of technology that any online retailer would. We can’t see the card number – only the last four numbers, giving us no way to use the card outside of the billing system. There is no way to export the card information out of our system.
What are the benefits?
It saves you time and eliminates the need to write checks, buy stamps or worry about delays in the mail. It also drives our administrative costs down because our staff sends out fewer statements and spends less time taking credit card information over the phone or entering it from the billing slips sent in the mail, which are less secure methods than us storing the information. The extra time the staff has can now be spent on directly helping the patients, either over the phone, with insurance claims or in person.
I always pay my bills on time. Why do I have to do this?
The entire billing process is time consuming and wasteful, and the few patients that we do have to send to a collection agency end up costing a lot of money. Reducing unnecessary costs are essential to allowing us to continue to be an in-network provider with most insurance companies. Nothing is changing about how much you end up paying.
What if there is a payment discrepancy or I have other payment questions?
Please contact our billing department directly to settle payment discrepancies or for other payment questions. This policy in no way compromises your ability to dispute a charge or questions your insurance company’s explanation of benefits.
Will I still receive a paper bill by mail?
Yes. You will receive one bill which will show what will be charged to your card in 30 days. If you prefer to pay by an alternative method, you may do so during that period. If you do not wish to make any payment method changes, just hold onto the statement for your records and your card will be charged.