What to Bring to Your Appointment
- Government Issued Photo Identification
- Copy of your Insurance Card (front and back)
- may be emailed directly to email@example.com
- Credit Card (as required by our financial policy)
If applicable, the following may be used for payments of services rendered:
- Health Savings Accounts/Flexible Spending Account Cards
- Please note, payment is due at the time of service, as outlined in our financial policy
- Many of these HSA/FSA cards occasionally are “frozen or locked” by the account managers if you don’t comply with their regulations.
- If payment is not processed due to a HSA/FSA card being declined, we will process payment using your regular credit card.
- If you do not have your HSA/FSA card present at the time of the appointment, we will not be able to process payment without the card.
- In order for us to send you an itemized receiptvia email we have to have written authorization from you. The itemized receipt will have HIPPA protected information, so if you want to receive it via email please send us an email denoting that you authorize us to send the itemized receipt to you via email firstname.lastname@example.org
- This is considered a waiver for us to share this information via email, which may not be entirely protected. Alternatively, we can provide an itemized printed receipt. Please note that itemized receipts may be provided 48-72 hours after your appointment, once all clinical documentation has been completed.
We recommend that prior to scheduling an appointment with Dr. Gabriel Martinez-Diaz, that you call your insurance provider and verify that we are in network for your insurance. When calling, please provide them with following information:
- Tax ID for M D Aesthetics and Dermatology: 81-4978438
- National Provider Identification (NPI) for Dr. Martinez-Diaz: 1245556695
- Practice’s NPI number MD Aesthetics and Dermatology: 1437678133
For patients with insurances that we are out of network, a self pay rate will be provided upon scheduling an appointment. Once the visit is completed, you may be provided with an insurance coded, itemized receipt, which you may send directly to your insurance company for reimbursement.
All patients may pay by either cash, Visa, American Express, MasterCard or Discover.
Please read more about our financial policy.
- Advocate Children’s Hospital
- Advocate Physician Partners – Includes HMO Illinois, Blue Advantage HMO, Blue Precision (You will need a referral from your primary care doctor, who may be affiliated with any of the following Advocate Hospital Locations, prior to be seen in our office)
- Basic Plus HMO-POS
- Blue Advantage
- Blue Advantage HMO (Please note to forward a copy of your insurance card to our office at the time of an appointment request)
- Blue Care Direct HMO
- Blue Cross Blue Shield PPO
- Blue Choice POS
- Blue Choice Select
- Blue Medicare Advantage Basic HMO
- Blue Medicare Advantage
- Cofinity PPO
- First Health
- First Health PPO (Please call your insurance provider to make sure your individual plan has dermatology coverage)
- Galaxy MCI
- Good Samaritan
- Good Shepherd
- Health Link PPO (Please call your insurance provider to make sure your individual plan has dermatology coverage)
- Health Smart (Please call your insurance provider to make sure your individual plan has dermatology coverage)
- Humana Choice Care
- Humana Commercial EPO/POS
- Illinois Masonic
- Lutheran General
- Medicare of IL
- NMPP Central Dupage
- NMPP Delnor
- NMPP Lake Forest
- NMPP DeKalb
- Private Healthcare Systems (PHCS) – Savility PPO, POS
- Preferred Plan
- South Suburban
- United Healthcare
- United Medicare Advantage
Questions with regards to billing are handled directly by our billing department, by calling 1-844-266-6366
If you would like to make a payment over the phone please call (312) 579-0700
About Your Health Insurance: FAQs
- Please remember that your health insurance is a contract between you and your insurance company.
- It is YOUR responsibility to know your health plan benefits, including co-payment amounts, deductibles, co-insurance, and lab contracts. As a service to you, we will submit a claim to your insurance company for all visit charges, but we do not share in the contract between you and your insurance company.
- A photocopy of your ID and insurance card is needed by our office to assist you in filing your claim.
- It is the patient’s responsibility to inform this office if your insurance requires pre-certification or pre-authorization of services prior to scheduling of such services.
- The patient will be responsible for services denied by insurance due to “No Eligibility”, “Non-Covered Service”, “Pre-authorization/Certification Not Obtained”. Statements are released after your insurance pays, denies, or non-payment by your insurance.
- What is a co-payment? A fixed fee that subscribers to a medical plan must pay, for their use of specific medical service covered by the plan.
- What is co-insurance? This is the amount a patient owes after insurance has been filed. For example: most insurance companies only cover 80%, 85% or 90% of allowed charges and the patient is responsible for the balance.
- What is a deductible? A deductible is the fixed amount you pay out of pocket before a health insurance plan begins to cover health care costs.
- What does in-network mean? In-network refers to health care providers that have agreed to provide services to a health plan’s members at a negotiated rate. Plan members usually pay less when using an in-network provider because the cost to the health plan is lower.
- When is a procedure considered cosmetic? Insurance companies rely on physicians to submit claims on procedures that in their opinion are medically necessary. If during an evaluation, you desired procedure is deemed cosmetic, you will be provided a cost-estimate which will need to be collected prior to performing the desired procedure. Cosmetic procedures could be but are not limited to: skin tags, acne/milia extractions and seborrheic keratosis, or mole removal. Any cosmetic treatments to improve appearance of the skin (i.e. neurotoxins, fillers microneedling) are considered cosmetic and not billable to insurance.
- What is an EOB? It is an Explanation of Benefits that is mailed to the patient and provider, showing amount billed, amount adjusted off, amount paid (if any) or amount applied to deductible.
- You are responsible for any charges not covered by your insurance plan. Any amount not covered by the insured/patient’s insurance is due at time of service.
- Some insurance plans require a prior authorization or a referral from a patient’s Primary Care Physician to see a Specialist. You can determine whether you need prior authorization or a referral by checking your insurance card or by calling your insurance company, using the telephone number on the back of your insurance card. Contact your Primary Care Provider if a prior authorization or a referral is needed for your visit. If either a prior authorization or referral is required, it must be received by us prior to you scheduling a visit with us.
Please remember to contact your insurance company directly for questions concerning your policy. We are not aware of the details of your selected policy. Understanding your policy will enable you to make an informed decision on your health care needs