Double co-pays at Advanced Dermatology

[RVRoadie]

My wife has used Advanced Dermatology for several years. During her last checkup, they identified two Basal Cell spots that required attention. One co-pay for diagnosis.

They required separate appointment for each spot. Ok, not unreasonable.

However, each removal required two co-pays. One for the Mohs doc to cut it out, and one for another doc to stitch her up. In the past, one doc has done both, for one co-pay.

She called BCBS to see if this was kosher, and they could care less.

So, a total of 5 co-pays for her annual checkup.

Looking for a new dermatologist.

[lake5798]

I used to use Village Dermatology, EVERY TIME I went in they did at least 6-8 scrapes for biopsies. It was costing me a small fortune as I have a High deductible BCBS plan. I started using Suncoast Dermatology a few years ago every 6 months. I have not had 1 biopsy performed to date, and I see a Doctor each visit, I do believe Dr. Tran's office does WAY to many indiscriminate biopsies. JMHO. Everyone I know who goes there comes home with a boatload of bandages on!!

[golfing eagles]

My wife has used Advanced Dermatology for several years. During her last checkup, they identified two Basal Cell spots that required attention. One co-pay for diagnosis.

They required separate appointment for each spot. Ok, not unreasonable.

However, each removal required two co-pays. One for the Mohs doc to cut it out, and one for another doc to stitch her up. In the past, one doc has done both, for one co-pay.

She called BCBS to see if this was kosher, and they could care less.

So, a total of 5 co-pays for her annual checkup.

Looking for a new dermatologist.

Just when I thought I had seen everything in medicine, you come up with this!!!

They required separate appointment for each spot. Ok, not unreasonable.

Actually it is. No reason not to allot time to do both, other than the reimbursement for 2 single excisions is more under CPT coding than excising two. The first appointment for "diagnosis" is reasonable, they need to schedule procedures at certain times so they don't back the office up for hours

However, each removal required two co-pays. One for the Mohs doc to cut it out, and one for another doc to stitch her up. In the past, one doc has done both, for one co-pay.


So, this doc comes in, I assume some sort of dermatological sub-specialist, removes the lesion and leaves it to someone else to close the skin? Can anyone spell "Prima Donna"? Cardiac surgeons do this routinely. They leave it to the assistant and residents to open the chest and harvest the graft, then they come in and sew in the graft or valve, then leave allowing the others to close. But this is because these are very long procedures and his time can be better spent helping other patients. (and they are Prima Donnas as well) But an office procedure of a few minutes!!!!

I would suggest the "stroke his ego" approach.---"Hey doc, you are obviously extremely good at what you do, my wife and I would appreciate your skill in closing the wound as well", plus it saves us a co-pay. If that doesn't work, I guess it is either eat the co-pay or find a new dermatologist.

[dbussone]

I used to use Village Dermatology, EVERY TIME I went in they did at least 6-8 scrapes for biopsies. It was costing me a small fortune as I have a High deductible BCBS plan. I started using Suncoast Dermatology a few years ago every 6 months. I have not had 1 biopsy performed to date, and I see a Doctor each visit, I do believe Dr. Tran's office does WAY to many indiscriminate biopsies. JMHO. Everyone I know who goes there comes home with a boatload of bandages on!!

I go to Dr Tran's office every 6 months. Over the last 3 years I've had 2 biopsies. Perhaps you and your friends spend too much time in the sun and/or need a different brand of sun screen.

[billethkid]

I used to use Village Dermatology, EVERY TIME I went in they did at least 6-8 scrapes for biopsies. It was costing me a small fortune as I have a High deductible BCBS plan. I started using Suncoast Dermatology a few years ago every 6 months. I have not had 1 biopsy performed to date, and I see a Doctor each visit, I do believe Dr. Tran's office does WAY to many indiscriminate biopsies. JMHO. Everyone I know who goes there comes home with a boatload of bandages on!!

Indiscriminate is an opinion, that which we are all entitled. However, to validate the opinion one would have to know how many in that boat load of bandages were cancerous VS nothing found. Then a case can be made or not.

The incidence of skin cancer is accelerated with exposure and "damage" is cumulative. Thus many start to bloom in the senior years.

My wife and I both go Dr. Tran. We have been over the 11 years here. I have had 3 biopsies two of which were sqamous. My wife had one biopsy which also was sqaumous. Three for four. Indiscriminate? I think not....many, many visits with no biopsies warranted.

Just offering another perspective for consideration.

[PennBF]

We have been patients of Dr Tram for a few years. They do have a sort of reputation for going to the knife a lot but I leave it up to them to make that judgement. A few years ago I had a small mark on my arm and 2 different Dr's said it was an infection and I did not believe either of them and did not fill their prescriptions. I ended up at the Urgent Care office in Sumter Landing and Dr.Proud said it was probably sgaumous cancer and cut it out. Had it biopsied and yep it was. Who did she refer me to "Dr.Tram". He cut it out and all is fine. That is enough for me. He is pretty busy and not stitching may be a better use of his "surgeon skills"? If I had a complaint about the Dr.Tram Office it would be that they allow you to wait in the waiting room for a long time. They do not respect your time. :ho: