Elevated Dermatology Insurance Forms

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. Unfortunately, we cannot see patients who have Medicaid insurance for any reason.