Forms & Insurance
Please download, read, and fill out your patient forms prior to your visit. Click the links below to download the forms and other documents about our policies.
- Patient forms and financial policy
- Notice of privacy practices
- The physician-patient relationship
- Patient rights and responsibilities
The team at Dermatology & Laser Center of Chapel Hill (DLC) participates with:
- Blue Cross and Blue Shield of North Carolina (BCBS) plans *see list below
- Cigna Healthcare
- United Healthcare (effective 1/24/18)
Here is a detailed list of the BCBS plans that we do and do not participate with.
We do accept:
- Blue Advantage
- Blue Care
- Blue Options
- Blue Select
- Classic Blue
- The North Carolina State Health Plan
We do not accept:
- Blue Value
- Blue Local
If you have other insurance that we do not accept, please make sure to get a receipt so that you may file a claim. Please note that insurance plans will most likely not cover cosmetic treatments.
How do deductibles, coinsurance and copays work?
A deductible is the amount you pay out of pocket for health care services before your health insurance begins to pay.
How it works: If your planâ€™s deductible is $1,500, youâ€™ll pay 100 percent of eligible health care expenses until the bills total $1,500. This is â€śmeeting your deductible.â€ť After your deductible is met, you share the cost with your plan by paying coinsurance.
Coinsurance is your share of the costs of a health care service. It’s usually figured as a percentage of the amount the insurance company allows to be charged for services. You start paying coinsurance after you’ve paid your plan’s deductible.
How it works: Youâ€™ve paid $1,500 in health care expenses and met your deductible. When you go to the physicianâ€™s office, instead of paying all costs, you and your plan share the cost. For example, your plan pays 70 percent. The 30 percent you pay is your coinsurance.
A copay is a fixed amount you pay for a health care service, collected when services are rendered.Â The amount can vary by the type of service.
How it works: Your insurance plan determines what your copay is for different types of services. You may have aÂ copay before youâ€™ve finished paying toward your deductible. You may also have a copay after you pay your deductible, and when you owe coinsurance.
Please contact your Insurance carrier directly for individual health care plan coverage benefits, limitations and questions.
If you have any questions about insurance or your bill, please contact DLC: