Understanding Your Insurance
We believe that understanding your benefits before your visit makes everything easier. Healthcare billing in the US can be confusing — we want to give you the tools to navigate it with confidence. If you ever have questions, our team is always happy to help.
Key Terms to Know
Copay: A fixed amount your insurance requires you to pay at the time of your visit. Think of it as your portion due upfront, collected at check-in.
Deductible: The amount you must pay out of pocket before your insurance begins to contribute. Until your deductible is met, you may be responsible for the full cost of services.
Co-Insurance: After your deductible is met, co-insurance is the percentage split between you and your insurance. For example, 80/20 means your insurance pays 80% and you pay 20%.
Out-of-Pocket Maximum: The most you'll pay in a given year. Once you hit this amount, your insurance covers 100% of covered services for the rest of the year — including your copay.
Coverage: A covered procedure does not mean there's no cost to you — it means the service applies toward your deductible. Non-covered services (like cosmetic treatments) do not apply to your deductible.
Prior Authorization: Approval required from your insurance before certain medications or procedures are covered. Our team handles this process on your behalf — it can take up to 30 days.
Global Authorization: An authorization that allows a specialist to provide ongoing in-office care without needing a new referral for every visit. Required for certain HMO plans. May not cover all services — procedures may still need a separate authorization.
Referral: Some plans — particularly HMOs — require a referral from your primary care provider before you can see a specialist. Please confirm with your insurance whether a referral is needed before your visit.
Why We Can't Give You an Exact Price Upfront
We get this question often and completely understand the frustration. Because every insurance plan has its own reimbursement rates, deductible rules, and co-insurance structure, it is not possible to give an accurate cost estimate for a visit or procedure until after it has been billed and your insurance has processed the claim.
If you'd like to know what a specific procedure might cost you, we can provide the procedure codes. You can then call your insurance company directly, give them the codes, and they can tell you your exact expected cost and responsible amount based on your specific plan.
We will always do our best to provide you with any information we have to help you get answers from your plan. Please don't hesitate to ask.
Insurance We Accept
We participate with most major commercial insurance plans, including Blue Cross Blue Shield, Aetna, Cigna, United Healthcare, Medicare, and most major PPO plans.
Being contracted with an insurance carrier does not guarantee we are in-network with every plan under that carrier. We recommend verifying that MDI is in-network with your specific plan before your visit. You can do this by searching your insurance company's provider directory online or calling the member services number on the back of your insurance card.
If your plan requires a referral, please obtain one from your primary care provider before your appointment. If you're unsure whether you need one, contact your insurance company or give us a call — we're happy to help you figure it out.
Billing & Statements
When should I expect my bill?
Insurance claim processing can take anywhere from a few weeks to several months depending on your plan. It is not unusual to receive a statement 2–4 months after your visit. If you were expecting a balance and haven't received anything, give our billing department a call and we can send you a statement. Please make sure your address and contact information are current with our office so statements reach you without delay.
How do I pay my bill?
We accept check and all major credit cards. Please make checks payable to Midwest Dermatology Institute. Please note that a 3% convenience fee may apply to card transactions. For billing questions, contact our billing department at 800-290-5282.
What if I receive an outside lab bill?
If a biopsy or specimen was taken during your visit, it is sent to an outside lab for analysis. That lab will bill you separately from MDI. The lab may or may not be in your insurance network — if you have questions about a lab bill, contact the lab directly using the information on your invoice.
Self-Pay Patients
If you do not have insurance or prefer to pay out of pocket, payment is due at the time of service. A non-refundable deposit is required when scheduling self-pay appointments and will be applied toward your visit total.
New Patient Office Visit — $180
Established Patient Office Visit — $150
Surgical Visit — $800
MOHS Surgery — $1,000
Deposit amounts are estimates. Final charges are determined after your visit and may vary based on the complexity of your condition and services provided. Any lab fees are billed separately.
Insurance Contacts
The resources below are provided to help you navigate your insurance benefits. While we do our best to keep this information current, contact details and plan information may change — we recommend calling the number on the back of your insurance card for the most accurate, up-to-date information.
Blue Cross Blue Shield of Michigan (BCBSM) Member Services: 800-843-4876 | bcbsm.com
Blue Care Network (BCN) Member Services: 800-662-6667 | bcbsm.com/bcn
Aetna Member Services: 1-888-792-3862 | aetna.com
Cigna Member Services: 800-244-6224 | cigna.com
United Healthcare Member Services: 1-866-801-4409 | uhc.com
Priority Health Member Services: 800-942-0954 | priorityhealth.com
Health Alliance Plan (HAP) Member Services: 800-422-4641 | hap.org
Medicare (Original Medicare) Member Services: 1-800-633-4227 | medicare.gov