Patient Forms & Insurance

Complete Paperwork at Home to Skip the Waiting Room for Bryn Mawr, Newtown Square, Philadelphia, and the Main Line

Patient/Client Information Forms can be downloaded, printed, and completed at home. Bring the completed forms with you to help make your visit more efficient and enjoyable.

Patient/Client Information Forms can be downloaded, printed, and completed at home. Bring the completed forms with you to help make your visit more efficient and enjoyable.

Bryn Mawr Skin & Cancer Institute / Cirillo Center for Plastic Surgery

Cirillo Cosmetic Dermatology Spa

Cirillo Center for Plastic Surgery

Insurance

Even if you uploaded your insurance card via our Appointment Reminder process, please bring the insurance card on the day you visit.  For medical dermatology and non-aesthetic plastic surgery, please be sure that any required referral has been processed.

Insurance co-pays are expected to be paid at the time of your visit.

We accept most major insurance carriers and Medicare. Please call your insurance provider prior to your first appointment to confirm that we are participating in YOUR insurance plan.   We do not participate in Medicaid.

Insurance coverage does not guarantee insurance payment.  Please keep current on your individual deductibles, co-pay

and co-insurance amounts.

Insurance Billing

For your convenience, you have the ability to agree to AutoPay your balance after insurance payments to reduce or eliminate the need for paper patient statements.  You can also pay your bill online via our simple and secure QuickPay feature.  Please see our AutoPay & QuickPay page for more specifics.

If you prefer to receive a paper statement in the mail, it will list any unmet deductibles, co-pay and co-insurance amounts due after your insurance has paid the portion covered by your plan.  Prompt payment is appreciated.

Aesthetic / Cosmetic Treatments  

Non-reconstructive, aesthetic plastic surgery treatments performed at Cirillo Center for Plastic Surgery, and cosmetic dermatology treatments performed at Cirillo Cosmetic Dermatology Spa, are out-of-pocket  non-insurance billable expenses.  A consultation will enable you to meet with one of our aesthetic providers to determine the best treatment plan for you.  Most, but not all, consult fees are applied to the cosmetic/aesthetic procedure when you proceed with treatment.

Prior Authorization

Some medical dermatology or plastic surgery procedures will require a prior authorization from your insurance company. One of our experienced prior authorization specialists will send a letter of medical necessity and photos to your insurance carrier for medical review. This can be a lengthy process. Please do not hesitate to contact us to check your prior authorization status.  It is your responsibility to ensure your insurance company provides you with your prior authorization.   If we do not have the prior authorization, we cannot perform the procedure because the insurance company will deny the insurance claim.