policies

INSURANCE

SWDA is a direct care practice, is out of network for all 3rd party insurance payers, and makes no representation that your claim will be reimbursed partially or in its entirety by your health insurance company.

Upon request on the date of service, privately insured patients can be provided with an itemized receipt. If CPT coding is requested, an administrative fee of $15 (time-related to looking up CPT billing codes) will be charged.

All questions regarding your insurance coverage and reimbursement should be directed to your insurance company or benefits manager. SWDA will not communicate with any insurance provider or benefits manager. 

Medicare and Medicaid patients cannot submit claims for reimbursement.

PRIOR AUTHORIZATIONS

An administrative fee of $50 will be charged per visit for work related to submitting prescription prior authorizations (if requested).   We utilize specialty pharmacies that often alleviate the need for the office to do the prior auth and the associated administrative fee while providing you with faster access to your medication often at reduced fees.                                    

CANCELLATIONS, NO SHOWS & LATE ARRIVALS

Late cancellations or missed appointments ( no show) prevent other patients from being seen in a timely manner. We require 2 business days’ notice for cancellation or rescheduling. A $100 non-refundable penalty will be charged for all late cancellations and no-shows. (ex: As our office is closed on Fridays, any Monday appointments must be cancelled by Thursday noon to avoid late cancellation fees and provide the office an opportunity to offer the time slot to another patient)

Procedures require a longer block of time. Inadequate notice will result in a non-refundable penalty charge of $100 OR forfeit of one service in a prepaid series OR 25% deposit for larger procedures. 

LATE ARRIVALS

To avoid inconvenience to other patients, SWDA will do its best to accommodate a late arrival with an abbreviated visit (no procedures) for the remainder of your scheduled time if it is possible and within reason for the medical staff. However, you will be charged for the full amount of your appointment time regardless of arrival time. 

PAYMENT                                      

SWDA does not participate in any health insurance plans and payment in full is required at the time of service. We accept cash, credit card, and care credit. Flexible spending accounts(FSA) or Health Spending Accounts (HSA) may be used for medical services only in accordance with account regulations. We do not accept personal checks.

COSMETIC APPOINTMENTS              

A cosmetic consultation is required prior to receiving any cosmetic procedures. A $100 deposit will be taken to reserve your appointment time.  This will be applied to your initial consultation.

PACKAGE TREATMENTS

Patients have one year from the date of package purchase to receive their treatments. We understand that extenuating circumstances arise and will work with you to accommodate your schedule. Package purchases are non-refundable and non-transferable.

PRODUCT RETURN POLICY

ALL products and prescriptions, whether opened or unopened, are non-refundable. If possible, we will be happy to offer you a sample to test. It is typical to see some irritation with certain products. Should irritation occur, please contact the office, stop using the product for a few days until symptoms resolve, and then resume with less frequency and add a gentle moisturizer.

PRESCRIPTIONS & REFILLS

To purchase products from the office, you must be a currently registered patient of the office. Refills may be given for up to 1 year from the last office visit at the discretion of the medical staff. Refill requests may be declined based on potential side effects, failure to present for follow-up visits, or extended absence from the practice.

GIFT CERTIFICATES

Available in any denomination, our gift certificates do not depreciate or expire. Gift certificates are non-refundable

CHILDREN

Unless they are the scheduled patient, please do not bring children with you. Our focus is on you and your treatment and we will not be able to watch children while treating you.

SAFETY & PRIVACY   

The use of recording devices in the office or exam rooms is prohibited. Any unauthorized recording or photography may result in dismissal from the practice.

All firearms/weapons regardless of conceal-to-carry permits are prohibited on our premises. Please store your firearm in your vehicle or leave it at home.

IMPORTANT NOTICE REGARDING INSURANCE

Skin Wellness Dermatology Associates ( SWDA) is a service-centric medical, surgical, and cosmetic dermatology practice with a focus on skin health and wellness. Please review the following practice policies and procedures.

SWDA is a direct care practice, is out of network for all 3rd party insurance payers, and makes no representation that your claim will be reimbursed partially or in its entirety by your health insurance company.

Upon request on the date of service, privately insured patients can be provided with a noncoded itemized receipt. If CPT codes are requested by the patient, an administrative fee of $15 (time-related to looking up CPT billing codes) will be charged to you. SWDA will provide you with a coded receipt to self-file a claim with your insurance company.

All questions regarding your insurance coverage and reimbursement should be directed to your insurance company or benefits manager. SWDA will not communicate with any insurance provider or benefits manager. 

PRIOR AUTHORIZATIONS

In an effort to reduce costs to you, we utilize specialty pharmacies that often alleviate the need for an office prior- authorization while providing you with faster access to your medication often at reduced fees.  If the office is requested or required to do the prior authorization, an administrative fee of $50 per request will be charged for work related to submitting prescription prior authorizations on a patient’s behalf.   

PRESCRIPTIONS, PATHOLOGY & BLOODWORK

For patients with insurance, you are able to use your benefits for pathology, laboratory work, and prescriptions.

At the time of biopsy, we will take a copy of your insurance card to submit to the lab with your biopsy specimen.

Pathology services are available at a reduced rate with a board-certified, fellowship-trained dermatopathologist for patients who prefer transparent pricing, or those with high deductible plans that prefer to pay out-of-pocket.

SWDA does accept traditional medicare only and will submit a claim on your behalf for noncosmetic visits.

SWDA is not contracted with any medicare supplements ( ex BCBS, united, aetna) , medicare HMO, or Medicaid.

If you utilize non-traditional Medicare, or Medicaid, we will require you to sign a contract every two years acknowledging that you are aware Dr. Jackson has opted out and you will be unable to be reimbursed by your insurance for any services provided by Dr. Jackson.

We respect your privacy and are committed to protecting it through our compliance with this policy.

Ways In Which We May Use And Disclose Your Protected Health Information ( PHI):

Appointment Reminders. We will use and disclose your PHI to contact you as a reminder about scheduled appointments or treatment.

Treatment Alternatives. We will use and disclose your PHI to tell you about or to recommend possible alternative treatments or options that may be of interest to you.

Others Involved In Your Care. We will use and disclose your PHI to a family member, relative, a close friend, or any other person you identify that is involved in your medical care or payment for care with your permission.

Research. If you consent to participate in a research project we will use and disclose your PHI to researchers provided the study has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

As Required By Law. We will use and disclose your PHI when required by federal, state, or local law. You will be notified of any such disclosures.

To Avert A Serious Threat To Public Health Or Safety. We will use and disclose your PHI to a public health authority that is permitted to collect or receive information to control disease, injury, or disability. If directed by the health authority, we will also disclose your health information to a foreign government agency that is collaborating with the public health authority.

Workers Compensation. We will use and disclose your PHI for Worker's Compensation or similar programs that provide benefits for work-related injuries or illness.

Inmates. We will use disclose your PHI to a correctional institution or law enforcement official if you are an inmate of that correctional institution or under the custody of the law-enforcement official. This information would be necessary for the institution to provide you with health care; to protect the health and safety of others; or for the safety and security of the correctional institution.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have a right to:

A Paper Copy Of This Notice. You may obtain a copy by printing it out from this website or by asking our receptionist at your next visit.

Inspect And Copy. You have the right to inspect and copy the protected health information that we maintain about you and our designated record set for as long as we maintain that information. This designated record set includes your medical information as well as any other records we use for making decisions about you. Requests must be made in writing and scheduled. We may charge you a fee for the costs of copying, mailing, or other supplies used in fulfilling your request.

Request Amendment. You have the right to request that we amend your medical information if you feel that it is incomplete or inaccurate. You must make this request in writing to our practice manager, stating exactly what information is incomplete or inaccurate and the reasoning that supports your request.

We are permitted to deny your request if it is not in writing or does not include a reason to support the request. We may also deny your request if:

The information was not created by us, or the person who created it is no longer available to make an amendment;

The information is not part of the record which you are permitted to inspect and copy;

The information is not part of the designated records that are kept by this practice;

If it is the opinion of the healthcare physician that the information that you wished changed is not accurate or complete.

Request Restrictions. You have the right to request a restriction or limitation of how we use or disclose your medical information for treatment, payment, or healthcare operations. For example, – you could request that we not disclose information about a prior treatment to a family member or friend who may be involved in your care or payment for care. Your request must be made in writing to our practice manager.

We are not required to agree to your request if we feel it is in your best interest to use or disclose that information.

An Accounting Of Disclosures. You have the right to request a list of the disclosures of your health information we have made outside our practice that were not for treatment, payment, or healthcare operations. Your request must be made in writing and my state the time for the requested information. You may not request information for any dates before April 14, 2003 (the compliance date for the federal regulation) nor for a period of time greater than six years (our legal obligation to retain information).

We will notify you of such cost and allow you to withdraw your request before any costs are incurred.

Request Confidential Communications. You have the right to request how we communicate with you to preserve your privacy. For example – you may request that we call you only at your work number or by email. Your request must be made in writing and must specify how or where we are to contact you. We will accommodate all reasonable requests.

File A Complaint. If you believe we have violated your medical information privacy rights, you have a right to file a complaint with our practice manager or directly to the Secretary of Health and Human Services.

Changes to Our Privacy Policy

It is our policy to post any changes we make to our privacy policy on this page. If we make material changes to how we treat our users' personal information, we will notify you through a notice on the Website home page. The date the privacy policy was last revised is identified at the top of the page. You are responsible for ensuring we have an up-to-date active and deliverable e-mail address for you, and for periodically visiting our Website and this privacy policy to check for any changes.

Contact Information

Any questions or comments about this privacy policy should be directed, in writing to our office manager.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost prior to receiving non emergent medical care.

Under the law, health care clinicians need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 877-696-6775.

SWDA is committed to protecting the health and safety of our patients, staff, and community.  

At this time, only scheduled patients are permitted in the office, no guests. If the scheduled patient is a minor or in need of assistance one additional person may attend the visit. The guest must be covid screened.

To avoid close contact with other patients, please complete all forms online PRIOR to your appointment

Masks are required to enter the office and should be worn properly over the nose and mouth for the duration of your visit. Refusal to wear a mask will result in the cancellation of your appointment.

Please utilize hand gel at the front desk upon your arrival.

Please cancel your appointment If you experience:

*flu-like symptoms (cough, fever, sore throat, or shortness of breath)

*loss of taste and smell

*have been exposed to COVID-19 within 10 days of your appointment

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