An Illustrative Mohs Patient Cost Estimating Workflow

What to Confirm Before Estimating

• Planned services: Confirm the procedures and expected stages with the clinical team. If the scope is uncertain, identify the assumptions that need to be explained to the patient.
• Payer and rate information: Check which fee schedule applies. Use the practice's contracted rates when available, and ask the billing team to review any uncertain payer rules.
• Patient benefit details: Confirm the deductible and co-insurance information used in the estimate. Missing or outdated inputs can change the estimated patient responsibility.

Prepare and Review the Estimate

• Select the procedures and payer. Enter the planned services and patient benefit information in DermEstimator, then review the configured fee schedule.
• Review the calculation. Check the selected codes and the multiple procedure adjustments shown in the estimate. Refer questions about coding or payer-specific rules to the billing team.
• Prepare a Good Faith Estimate when applicable. Generate the document, then review the expected charges, patient notices, and applicable requirements before sharing it.
• Explain the assumptions. Discuss how changes in services, benefits, or payer processing could affect the final amount. An estimate is not a guarantee of coverage, reimbursement, or patient payment.