Welcome to Advanced Dermatology Care and Advanced Esthetics Med Spa!
Information for New Patients
Please review the information below and call
651-484-2724
with any questions.
To help us serve you better, please arrive 10 minutes prior to your appointment and bring the following items:
- Insurance card
- Photo identification
- Copay
- Current Medications
- Insurance referral (if needed by your Health Insurance plan)
Profile Photos are Required. If you wish to be seen as a patient at ADC, you must comply with the requirement for a Profile Photo.
In order to use your insurance, the Clinic must comply with insurance requirements.
Part of these requirements include making sure that no identity fraud is present. This includes taking a photo for your chart to verify that you are the person using your insurance.
Patient Forms – Click Section Below
***Please make sure that before you arrive for your appointment you have had the chance to speak with your insurance company to ensure that our clinic is in your network and a referral from your primary physician is not required. We do not require a referral, however your insurance company may require a referral. Call the customer service number on your insurance card, to see if we are in your plan or if you need a referral to see us. You are responsible for providing accurate, current insurance information. If you do not have an active insurance card with you for your appointment, it is your responsibility to contact your insurance company for your current information which may result in a late appointment.
We take ID photos of all patients for security purposes and fraud prevention.
Patient Forms
By filling out your Patient Medical History Form ahead of time, you will save a significant amount of time during your visit. If you prefer to complete your patient forms in our office, please arrive 15 minutes before your appointment. Please be prepared to provide this information to our office along with your current medical insurance information. If you have any questions when filling out these forms, please bring them with you on the day of your visit and our staff will assist you.
Additional Patient Information
We accept the following insurance plans:
Advanced Dermatology Care accepts these insurances but it is the patient’s responsibility to know their coverage. We highly suggest calling your insurance for benefit information including but not limited to deductibles, co-insurances, co-pays, and network information.
- America’s PPO
- Medicare
- Aetna PPO/MC
- Patient Choice
- Blue Cross/Blue Shield
- Preferred One
- Health Partners
- Private Health Care System
- Many PPO’S
- Select Care
- Medica Choice
- United Healthcare
- Medica Elect
- Ucare
Attention MA/Medicaid & Veterans
- Please note* We are NOT providers for Medical Assistance/Medicaid programs through the state and therefore do NOT bill directly to those plans. You may still choose to be seen at our clinic, however it will be at your own expense and payment in full will be due at the time of the visit.
- PLEASE NOTE* We are NO LONGER providers for HEALTH NET/ VETERAN’S CHOICE/ VETERAN’S ADMINISTRATION. You may still choose to be seen at our clinic, however you will need to have a copy of an active insurance on file or your visit will be at your own expense and payment in full will be due at the time of the visit.
Fees/Payments
Fees for co-payments, cosmetic services, and private insurance are collected at the time of your visit.
Important information for Minors/Patient Representatives
Minors
- Any Child or young adult less than 18 years of age must have a parent or legal guardian present with them for the initial visit and any subsequent visits requiring a procedure not previously performed at ADC.
Patient Agent/Representative Information
- ADC requires copies of any legal documentation for a person to be an Agent/Representative for a Patient.
- A Patient Agent / Representative is a person legally able to make decisions for a patient if/when they are unable.Types of Agents / Representatives:
- Health Care Directive / Advance Directive – access does not end upon the patient’s death
- Power of Attorney (Health / financial) – access ends upon the patient’s death
- Guardian – Patient must be under the age of 18*Note: For deceased patients Medical Records can be released if appropriate documentation is provided by the person with legal authority to do so. These individuals include:- Surviving Spouse
– Parent (If no Spouse)
– Health care agent
– Executor of the estate
– Person(s) identified in last will and testament
**A court order or search warrant signed by a judge can also authorize the release**
Please fill out this form if you are a Patient Representative or Patient Agent.
Patient Portal Sign Up
24-7 access to your medical information, from the comfort of your home!
- Login from your computer, or use the convenient APPatient app
- Manage your own health records, as well as your family members
- Send messages to your provider and receive responses
- Request prescription refills
- Complete paperwork prior to appointments
- View information, prescriptions, and lab results from medical visits
- View upcoming and past appointments, and request new ones (coming soon!)
- View statements and pay bills securely
- Request copies of your medical records
- Access educational tools to learn about a variety of medical topics (overall wellness, not just dermatology!), check symptoms, learn about medications, and make decisions related to your health
Questions about the billing process or insurance? View our Billing-and-Insurance-FAQ.
Need Adobe Acrobat Reader?
Patient Forms are provided in a .pdf format. You will need Adobe Acrobat Reader to open and print these forms. If you do not have a copy of Acrobat Reader, you can get a free download by clicking on this Acrobat Reader link.
