Insurance, Co-Payments, Insurance Plans
Your insurance coverage is an agreement between you and your insurance company. Financial responsibility rests with the patient for co-payments, deductibles, co-insurances, and non-covered services. Insurance coverage is a variable and we cannot guarantee what services will be covered by your particular plan. If your insurance plan requires a referral from a primary care physician, you are responsible for obtaining the necessary referral. It is your responsibility to know the requirements of your insurance program. We will ask you to sign an authorization form requesting that insurance payments be sent directly to our office when appropriate.
We accept most insurance plans with a few exceptions. We are an out-of-network provider for all CareSource plans. We may be out-of-network with some Medicaid and some employer plans. If you are uncertain, please check with your insurance plan.
United Healthcare Medicare Plans require pre-approval.
Please call our office to inquire if you have questions.
Co-Payments, Coinsurance, Deductibles And Outstanding Balances Are Due At The Time Of Service
All applicable co-payment, deductible and coinsurance and outstanding balances will be collected at time of service. Full payment is required for all non-covered services.
For your convenience, we accept personal checks, Visa, MasterCard, Discover, American Express, Care Credit and cash.
If you have any questions or concerns, please contact our billing department at 937-293-5567, option 4.
Nonpayment, Collection Costs and Returned Check Fee
Nonpayment of your account balance may result in transfer of collection efforts to an outside collection agency and credit damage. In the event your account is referred to a collection agency or attorney for collection, you will be responsible for all collection fees, attorney fees, court costs, and expenses. A $30.00 fee will be added to your account for each returned check.
There is no charge for cosmetic consults with our aesthetician. Patients who have a cosmetic consult with a physician will receive credit in the amount of the consult toward their cosmetic procedure, if scheduled and performed within 6 months.
Cosmetic Services Payment / Cancelation
Cosmetic service and Laser patients will be required to make a $100 deposit at the time of scheduling. The deposit will be credited toward the service cost at your visit. We require 24 hour notice to cancel of reschedule your appointment. If you cancel with less than 24 hours notice or no-show for the appointment, you will forfeit your deposit. Deposits will not be refunded.
Sculptra requires a $400 deposit. Product must be constituted a number of days prior to injection, therefore we require 5 days notice to cancel or reschedule your appointment. Failure to provide a minimum of 5 days notice will result in a charge of $400 per vial to cover the cost of product loss.
Aesthetic, Cosmetic and Laser Service Packages
Package purchases must be paid in full at the time of scheduling. Refunds will only be made if requested prior to the first treatment. No refunds will be made following the first treatment, whether subsequent treatments are used or unused.
Retail Product Refunds
Dayton Skin Care Return Policy:
Unused/Unopened Product: 15 days from the purchase.
If you experience an adverse/allergic reaction, contact the office within 2 business days of purchase. Returns will be accepted at the physician’s discretion.
Clarisonic Returns: Contact Clarisonic Customer Service at 888-252-2742
Pathology and Lab Fees
Biopsies may be sent to a lab to be analyzed. The fee for this is a separate charge from the office visit. You may receive a bill from Dayton Skin Care for the physician service and a separate bill from the processing lab. Results are usually available 7-10 days after the test has been performed. Questions regarding payments for laboratory services should be discussed with the lab.