Forms & Policies

New Patients

Thank you for choosing Trinity Dermatology Carrollton, now a part of U.S. Dermatology Partners! We appreciate the opportunity to care for your health. Please begin the registration process by completing our forms. You have the option to fill the forms online or print the forms and fill them out by hand.

  • Click here! to fill the forms online (preferred method). You can access this link on your desktop computer or mobile phone. No app is required. All your information will be submitted electronically, and you do not need to print the completed forms.
  • Click here! to print the forms and fill them out by hand. Please remember to bring your completed forms to your initial appointment.

Please bring a valid photo ID, current insurance card, and a form of payment to your initial appointment. To expedite the check-in process, please arrive 10-15 minutes prior to your scheduled appointment time.

Minor Consent

If the patient is a minor (under 18 years of age), the parent or legal guardian must be present at the child’s initial visit to sign the Consent to Treat Minors form. Without a signed consent form, we cannot legally treat a minor child. The form allows you to list other adults who can accompany your child or if your child can arrive unaccompanied to future visits. If you are unable to attend the first visit with your child, you may sign the notary version of the parental consent form. If you are the child’s legal guardian (not a parent), you will need to confirm this by providing legal documentation. This information will be kept in the child’s file.

Established Patients

Please bring a valid photo ID, current insurance card, and a form of payment to your appointment. To expedite the check-in process, please arrive 10-15 minutes prior to your scheduled appointment time.

Late Arrivals

We understand that sometimes you may be delayed. However, late arrivals may require rescheduling. U.S. Dermatology Partners reserves the right to charge a fee if the appointment is not canceled at least 24 hours in advance. Special types of appointments require a deposit to reserve the appointment date. U.S. Dermatology Partners reserves the right to charge a fee or retain the deposit if the appointment is not canceled at least 72 hours in advance.

Insurance

We accept most major insurance carriers. Find the complete list of insurance carriers that we accept here. However, please contact your insurance company prior to scheduling your appointment to verify the specifics of your coverage. Also, it is important to ask your insurance carrier if any referral, pre-authorization, or pre-certification is necessary before you schedule your appointment with us. HMO carriers require preauthorization prior to treatment.

Payment

Payment is due at the time services are rendered. The amount collected is estimated based on benefit information available. Specific policy information is often limited or unavailable until after a claim has been filed. Insurance coverage is not a guarantee of payment. The patient is responsible for any remaining balance not covered by insurance.

Our Fee Policy

Due to the overwhelming number of insurance plans, it is impossible for our front desk staff to guarantee any coverage by any individual insurance plan. Everyone’s insurance is different, even those with the same employer and insurance company! Each patient is responsible for knowing their own insurance coverage including the deductible, co-insurance, the amount met, the copay amount, and the coverage policies for procedures. Each patient is also responsible for obtaining their referral and knowing the number of visits, the effective date, and the expiration date of that referral.

Our office attempts to verify each patient’s insurance benefits with their insurance company, prior to their visit. At check out, each patient is charged according to the insurance benefit information and fee schedules that we receive from their insurance company. Once the insurance claim has been processed and an explanation of benefits (EBO) is received, a bill or credit will be issued if necessary.

Most insurance companies require the payment of a deductible for any in-office procedure. Procedures include things such as the destruction of warts and actinic keratoses, the injection of psoriasis and scars, and the excision of cysts, skin tags, and skin cancers. These procedures are very seldom cover under the co-pay alone! All deductible charges and co-payments must be paid at the time service is rendered. If you are unable to comply with this policy, please reschedule your appointment for another time.

Trinity Dermatology, PA is a specialist office and as defined by the insurance companies, it is not a primary care provider (PCP). The fee schedule for each procedure has been predetermined by each participating insurance company by contract with Trinity Dermatology.

Laser and Cosmetic Appointments

When booking a laser or cosmetic dermatology appointment, a credit card is required. If a 24-hour notice is not given to cancel your appointment, a $50 charge will apply. No appointments will be scheduled without a credit card.