Office Information

Our Location

The Dermatology Center at Ladera

600 Corporate Drive, Suite 240
Ladera Ranch, CA 92694
Fax: (949) 364-8511
Tel:
(949) 364-8411

Office Hours

Monday: 8:00 AM - 5:00 PM
Tuesday: 8:00 AM - 5:00 PM
Wednesday: 8:00 AM - 5:00 PM
Thursday: 8:00 AM - 5:00 PM
Friday: 8:00 AM - 4:00 PM
Saturday: Closed
Sunday: Closed

 

For more information or to schedule an appointment, please call us at (949) 364-8411.

If you have a dermatologic emergency after hours or on weekends and are currently under their care, please call to get the on-call number for Dr. Lener, Dr. Fogelson, or Dr. Mundi.  If it is a true medical emergency, please call 911.


Payment Policies

For your convenience, we accept cash, check, Visa, MasterCard, and Discover. To make a payment please call (949) 207-6082 or Pay Online.


Insurance Plans and Policies

Physicians at The Dermatology Center at Ladera accept appointments for patients regardless of their insurance status.

We participate In-Network with most standard PPO plans except United Healthcare, however we are out-of-network for most of the narrow network PPOs.

We have also set up our fees and self-pay discounts so that patients who value our high level of care can be treated at reasonable rates, regardless of their insurance status or network.  If you are Out-of-Network or self-pay, you can ask our team for a treatment quote in advance.

It is our recommendation that patients call their insurance about a week before their visit and ask if your doctor at our office is in their Network, and what specific benefits will apply.

We are In-Network for most major PPO & POS plans, including:

  • Medicare & Medicare Supplemental
  • Tricare Select and Tricare for Life Supplemental
  • Anthem Blue Cross – only traditional “Prudent Buyer” network, Medicare PPOs, and out-of-state BlueCard PPO
  • Blue Shield – only standard/full/OffEx network, Medicare PPOs, and out-of-state BlueCard PPO
  • Cigna
  • Aetna
  • HealthNet
  • Humana/ChoiceCare
  • First Health/Coventry
  • Multiplan
  • Beechstreet

And In-Network with the following additional plans:

  • Affiliated Health Funds PPO
  • America’s Choice Provider Network PPO
  • Bellflower Unified School District
  • CorVel PPO
  • First Access PPO
  • Fortified Provider Networks PPO
  • Galaxy PPO
  • Healthsmart PPO
  • Network by Design PPO
  • Orange County Foundation for Medical Care PPO & EPO
  • Prime Health Services PPO
  • Private HealthCare Systems PPO
  • Provider Select PPO
  • Stratose/National Preferred Provider Network
  • Three Rivers Provider Network
  • USA MCO PPO 

For patients who are covered under of one of the PPO plans in which we are In-Network, we will ask for any co-pay at your visit. If patients have no co-pay, but a high unmet deductible, we will ask for $50 as their co-pay at each visit.

It is our policy and practice to collect the full patient cost sharing including the co-pay, co-insurance, and deductible because we are contractually obligated to do so.

Narrow PPO Networks:

Narrow PPO networks are setup by insurance companies as a more restricted set of providers within a PPO. Narrow networks are often called Select, Exclusive, Local, Enhanced, or other descriptors. We do participate in the traditional, broad PPO networks, but we do not participate in most of the narrow PPO networks. In years past, these plans were primarily for individual/family plans, but are increasingly sold to employer groups. Insurance companies are also giving designations to some physicians and not to others for unknown reasons, and this can impact patient cost sharing, so it is important for you to check if your specific physician is covered at our office by your plan.

We will do our best to keep the following information up to date, as it becomes available to us. The following is the best information we have on major narrow PPO networks and designations:

  • Anthem Blue Cross narrow networks are any plans using the “Select“, “Pathways“, “Tiered”, or National BlueCard PPO Basic “PPOB” networks; we are Out-of-Network for these.  These plans are sold on the CoveredCA.com State Exchange, as off-exchange individual/family plans, or as group/employer sponsored plans. Narrow Anthem networks also include any plan identified with “Alternate Network” and Vivity.
  • Blue Shield has narrow networks known as the “Exclusive” or “Mirrored” PPO network which is used for all plans sold on the CoveredCA.com state exchange, and “mirrored” plans sold off-the-exchange to individuals/familys or employer groups; we are Out-of-Network for these. On the positive side, some Blue Shield narrow network plans pay 50% of “allowable/discounted” fees for out-of-network care. 
  • Aetna has a Savings Plus of California designation, which only Dr. Lener and Dr. Fogelson have, which may affect cost sharing in a few Aetna plans.
  • HealthNet has PureCare One EPO and PureCare HSP, with which we are participating In-Network. However, “EnhancedCare” PPO is a newer narrow network plan sold by HealthNet on the Covered California Exchange, and we are Out-of-Network with it.
  • Cigna’s LocalPlus is a narrow network with which we are In-Network. We are in the following Cigna PPO networks: Open Access Plus, Local Plus IN, ChoiceFund Open Access Plus, ChoiceFund LocalPlus, and Choice Fund LocalPlus IN. All our dermatologists now have the Cigna Care Designation.
  • Tricare Prime is a hybrid PPO/HMO plan that patients can opt into, which has higher patient cost-sharing unless the patient gets a referral from their PCM.  Patients are responsible to get referrals in advance of their appointment here.  Our office is not responsible for any referrals, and we must fully collect patient cost-share as determined by Tricare on all claims.

We are Out-of-Network for:

  • United Healthcare PPO
  • Anthem Blue Cross EPO and Individual/Family plans
  • Blue Shield Individual/Family plans
  • CoveredCA.com State Health Exchange plans, except HealthNet
  • Most Narrow PPO Networks
  • Oscar
  • Tricare Direct Care
  • HMO Only patients assigned to a Medical Group, IPA, or PCP, including: Kaiser Permanente, Monarch, SCAN, Greater Newport Physicians, Mission Hospital Affiliated Physicians, Mission Internal Medicine / Mission Heritage / St. Joseph Health, MemorialCare, and others
  • Medicare Advantage HMOs
  • Medicaid / Medi-Cal / Cal-Optima
  • Healthy Families (SCHIP)
  • Worker’s Compensation
  • Auto Insurance plans

Patients with United Healthcare PPO or Blue Shield PPO that is considered by our staff as out-of-network/narrow-network will still only be asked to pay just their co-pay at their first visit, and we will submit the claim to their insurance. After insurance processes the claim, we will send the patient a statement for the remaining balance not paid by co-pays and their insurance. Our office will continue this process as long as the patient’s insurance processes the claim without an outright denial and patients make timely payment of their portion of the balance. Patients’ Out of Network deductible, which is typically higher, will usually apply to these claims.  Patients in other out-of-network plans will be asked to pay our office directly for their care on the date of service. 

We always do our best, but is not our responsibility to confirm our network participation status with your specific plan.

Self-Pay Discounts

If you are Out-of-Network or Self-Pay (e.g., no medical insurance), you can request a treatment quote in advance based on our reasonable, discounted price list we will provide in the office.

Some restrictions do apply. For example, payment must be made by patients on the date of service to receive the discount. We cannot offer discounts to patients with insurance with whom we are In-Network, and we will not submit any claims. These discounts are not based on and do not apply to any of our non-medically necessary or cosmetic services, and the discounts cannot be combined with any other discounts. 

As a rule, In-Network prices are the lowest, so patients with high deductibles that are In-Network are better off using their insurance.

Please direct any questions to our billing team at (949) 207-3182.

Understand your plan network and benefits

It is our recommendation that patients call their insurance about a week before their visit and ask if your doctor at our office is in their Network, and what specific benefits will apply.

If we are out-of-network, patients should ask what benefits they have for out-of-network providers, so that there are no financial surprises.  Sometimes there is a separate deductible or other payment differences for out-of-network care.  We have many patients that are cared for on an Out-of-Network basis and are pleased with how it is handled at our practice.

Thank you for taking the time to understand our insurance policies. Our mission is to provide high quality Dermatologic care. Insurance details can be challenging – please contact our billing team at (949) 207-3182 with questions.


Patient Portal

The Patient Portal gives our patients secure 24/7 web access to their medical information from the comfort and privacy of their own home or office.  Our staff will web enable patients at the appropriate time during office visits, and your username and password will be emailed to you.

This service is free to all established patients.

Through the Patient Portal, patients are able to:

  • Receive Biopsy and Lab Results
  • Get appointment confirmation and reminders via email
  • Send and receive messages from doctors and staff (please allow 2-3 days for response)
  • View current and past appointments
  • Review medications and request prescription refills
  • Update contact information
  • Access medical record
  • View current and past statements, and make payments

Our office will make efforts to web-enable all patients. If any established patient would like to be web-enabled before their next visit, just call the office and our staff can do that for you. New patients will not be web-enabled until they arrive for their first visit.

The portal is not for diagnosis, treating new conditions, or urgent messages.

LOG INTO PATIENT PORTAL

Your confidentiality is important to us. When you connect to the portal, you are connected to a secure website. Only the limited information you see is securely stored on the portal, but your actual records are maintained securely in our office. If you wish to deactivate the service, just let us know. All internet communication via the portal is recorded in your medical record. Staff members other than your physician will be involved in receiving your messages, and routing them to the doctor or staff as necessary. You may certainly use the website at any time, however, we will most likely not respond until our usual business hours. We will do our best to respond to any portal requests as quickly as possible, but because your doctor may not be working every day, please allow us 2-3 business days to respond.

If you have any questions or comments about the patient portal, please contact our office staff.