Download our patient registration form in PDF format to expedite your visit to Elevated Dermatology. If you prefer, you can fill out your forms through our portal (call or text 720-851-5200 for details) or come to your appointment 15 minutes early and fill out your forms in our office.
Download our parent or guardian consent form in PDF format if you want your minor child to be seen for an office visit or have any procedure done without you present. Send completed form to patient@elevatedderm.com or text a photo of the completed form to 720-851-5200. Parent or guardian must be present at first visit.
Download our medical record release form to request records from your previous office be sent to our office. Send completed form (we must have the specific location and fax number) to patient@elevatedderm.com or text a photo of the completed form to 720-851-5200 and we’ll do the rest!
Understanding your financial responsibility is an essential component in establishing and maintaining a strong patient/practice relationship. Your insurance coverage is a policy that you have purchased and is a contract between you and your insurance company. It is your responsibility to know and understand the terms, guidelines and limitations of your coverage. It is also your responsibility to advise us of any changes in your insurance, your address or your employer. Please remember that it is ultimately your responsibility for the payment of all medical bills.
We ask that you confirm that Elevated Dermatology is in network with your insurance plan prior to being seen. This can be done by calling the customer service number on the back of your card or logging into your insurance company’s website and checking through their system.
If your insurance requires a referral, ensure that we have this on file prior to being seen. Your visit will not be covered, resulting in a large out of pocket expense to you.
If we do not participate with your insurance carrier, you have the option to pay a discounted self pay rate which is due on the date of service.
We do not accept the following insurances (this may not be a complete list):
Aetna
Aexcel
Cigna
SureFit
Connect
Colorado Health Partners
All plans
Colorado First Health/Medicaid
Friday Insurance
All plans
Humana
HMO X
Multiplan
Worker’s Comp
Auto Medical
Value Point
PHCS
PHCS Savility
Rocky Mountain Health Plans
Medicare Cost
Denver Health
All plans
Kaiser
All plans except those that are in PHCS network
United
Charter EPO/HMO/HMO Plus/POS
Compass EPO/Exclusion/HMO/HMO Plus/POS
Core EPO/HMO
Core Choice Plus
Navigate EPO/HMO/HMO Plus/POS
Veterans Affairs CCN
