We use Amarillo Pathology Group to read/prepare all of our biopsy specimens, you will receive a separate bill for those services. Please contact them directly at the number provided on their statement.

All copayments and deductibles are due at the time of the office visit. Any remaining balance after the insurance has paid is the patient’s responsibility and is due upon receipt of the bill. If your account has a balance due, please plan to pay that balance before or at the time of an upcoming appointment. Patients without insurance coverage should be prepared to pay their visit balance of the date of the visit. We accept cash, checks, Visa, Mastercard, Discover and American Express. Our office charges a $30(plus tax) returned check fee. Past due accounts are turned over to a collection agency.

We use New Horizon Billing Service, if you have a question about your bill please call 806-355-9595.

For cancellations please contact our office at least 24 hours prior to the scheduled appointment. We reserve the right to charge a $45 fee for late cancellations and missed appointments. A $100 non-refundable deposit is required for elective procedures.

Medical records can be obtained by the patient or sent to another office with the completion of a written request. A $25 fee may be charged for these records.

All medical records are protected as required by law. Copies of our privacy policy are available at the office.

High Plains Dermatology Center, PA complies with the applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR 92.101(a)(2). High Plains Dermatology Center, PA does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.
If you need reasonable modifications, appropriate auxiliary aids and services or language assistance services, contact the office manager. High Plains Dermatology Center, PA provides language assistance services or appropriate auxiliary aids and services free of charge in its health programs and activities, when necessary for compliance the section 1557.

If you believe that High Plains Dermatology Center, PA has failed to provide the services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex. You can file a grievance with: Office Manager, 4302 Wolflin Ave, Amarillo, TX 79106, Telephone (806)355-9866, Fax (806)355-4004. You can file a grievance in person, by mail or fax. If you need help filing a grievance, the office manager is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office of Civil Rights, electronically through the Office for Civil Rights Complaints Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence avenue SW, Room 509F HHH Building, Washington, DC 20201, Telephone (800)368-1019, TDD (822)537-7697
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
This notice is available in English, Spanish and Vietnamese at High Plains Dermatology Center, PA website: highplainsdermatology.com

Please bring a list of all medications the patient is taking (including prescription topical creams and over-the-counter creams or medicines) to each visit. If a 3-month supply is required, please inform the physician before they write the prescription. If you need a refill, please contact your pharmacy first and allow 48 hours for all refill requests

Minor patients must be accompanied by a Parent or Legal Guardian (proper documentation must be presented at time of initial visit) for their initial visit to review treatment options and to consent to the treatment care plan.

After minor patient’s initial visit, you can discuss with their physician other options for future appointments. If you designate a friend or family member to bring the minor patient after the initial visit, you will need to fill out our Minor Consent Form.

I authorize CBSA Collection to contact me via current and any future cellular phone number (s), email address(es) or wireless device(s) regarding my delinquent account(s) or debt I owe to High Plains Dermatology Center or to receive general information from High Plains Dermatology Center. I also authorize CBSA and its agents, representatives, and attorneys (including collection agencies) to use automated telephone dialing equipment, artificial or pre-recorded voice or text messages, and person calls and emails in their effort to contact me for purposes of collecting any portion of my account financial obligation which is past due. Furthermore, I understand I may withdraw my consent to call my cellular phone by submitting my request in writing to CBSA or its agents on behalf of High Plains Dermatology Center.