How DermEstimator Works
Front desk staff at dermatology practices face a recurring problem: patients ask what their visit will cost, and the honest answer is "I'm not sure." Manual estimates mean looking up fee schedules in spreadsheets, guessing at deductible balances, and hoping the numbers are close enough. When they're not, practices absorb patient complaints, delayed payments, and — since the No Surprises Act — potential compliance exposure. DermEstimator eliminates all of that in four steps.
Select the Patient's Insurance
DermEstimator comes pre-loaded with the most common insurance configurations seen in dermatology — Medicare Part B, Medicaid (major state plans), and the commercial carriers that represent the bulk of a typical derm practice's payer mix. Select the patient's plan from the dropdown and the correct fee schedule is applied automatically.
Contracted rates are stored as a percentage of the Medicare Fee Schedule. When you select a payer, DermEstimator multiplies each procedure's 2026 MPFS allowable by the contracted rate to arrive at the true allowed amount — not a charge amount that insurers will reduce anyway. This is the number that actually determines patient responsibility.
Custom payers are fully supported. If your practice has a local or regional plan not in the default list, you can create a custom payer entry with its own contracted rate percentage or upload a flat-dollar fee schedule via CSV. Custom payers are saved to your account and available to every staff member immediately.
Add the Planned Procedures
Type any part of a procedure name or CPT code into the search field and matching results appear instantly. DermEstimator's code library contains over 525 dermatology-specific CPT codes drawn from the 2026 Medicare Physician Fee Schedule — every excision, biopsy, destruction, Mohs surgery stage, add-on code, and E&M code your practice uses.
Codes are grouped into logical categories — Office Visits, Biopsies, Excisions, Mohs Surgery, Destruction / Cryotherapy, Cosmetic, and more — so staff can browse by procedure type if they don't know the exact code. Each code displays its full descriptor alongside the allowed amount, so there's no ambiguity about what's being estimated.
As codes are added to the estimate, DermEstimator automatically checks for the multiple procedure rule (MPPR) and applies the 50% reduction to secondary procedures where required. Add-on codes that are exempt from MPPR — such as 17312 and 17314 in Mohs surgery — are handled correctly without any manual adjustment.
Enter the Patient's Cost Share
This is where most manual estimates go wrong. The correct order of operations is: apply the deductible first, then calculate co-insurance on the remainder. Many spreadsheet-based tools get this wrong, either applying co-insurance to the full allowed amount or skipping the remaining-deductible check entirely. DermEstimator enforces the correct logic every time.
Enter the patient's remaining deductible balance and their co-insurance percentage. For Medicare patients, the 20% co-insurance is pre-populated — you just need to confirm whether the patient has a Medigap supplement that covers the co-insurance. If they have a flat copay plan instead of co-insurance, that's supported too.
The estimate updates in real time as you adjust these values. Staff can show patients the math immediately — "your deductible is $340, the procedure is $280 allowed, so you'd owe the full $280 today with nothing going to co-insurance." That kind of specific, confident answer reduces checkout friction and increases same-day collections.
Share the Estimate
Once the estimate is complete, you have three options. The itemized breakdown view shows each procedure, its allowed amount, the deductible portion, the co-insurance portion, and the patient's total responsibility — formatted cleanly enough to show a patient on-screen during check-in.
Every estimate is saved to the account's estimate history automatically. This creates a permanent, timestamped audit trail — essential for demonstrating compliance if a patient later disputes what they were quoted, and valuable for tracking estimation accuracy over time.
For practices subject to the No Surprises Act's Good Faith Estimate requirements, a single click generates a GFE-compliant document using federally required language and formatting. The GFE is pre-populated from the estimate data — no re-entry required. See our dedicated GFE page for full details on NSA compliance.
Why This Beats a Spreadsheet
Spreadsheets can store numbers. They can't reason about billing rules. Here's what DermEstimator does that a spreadsheet never will:
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Automatic multiple procedure rule (MPPR) application. When a patient has two procedures, the second procedure is reimbursed at 50% of its allowed amount under Medicare rules. Getting this wrong overstates patient responsibility and erodes trust. DermEstimator applies MPPR automatically across all covered codes, with correct add-on code exemptions.
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Locality-adjusted Medicare rates. Medicare pays different amounts for the same procedure in different geographic areas — the same excision that reimburses $180 in Mississippi may reimburse $240 in Manhattan. DermEstimator covers all 109 Medicare localities with GPCI-adjusted rates, with ZIP code auto-detection to set the correct locality for your practice.
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Permanent audit trail. Every estimate is timestamped and saved. Spreadsheets get overwritten. DermEstimator's estimate history gives you a searchable record of every quote your practice has generated — what was quoted, when, and for which procedures. Essential for dispute resolution and compliance documentation.
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Good Faith Estimate compliance, one click. The No Surprises Act requires GFEs for self-pay and underinsured patients requesting scheduled services. Generating a compliant GFE from a spreadsheet estimate means manual re-entry into a template, with all the error risk that implies. DermEstimator generates the GFE directly from the estimate — no copy-paste, no template hunting.
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