Signature Dermatology is proud to offer auto-payment of medical bills. To do this, we use an Electronic Funds Transfer (EFT). Patients can keep a credit card or other method of payment on file with our office.
There are two options with your EFT:
-I prefer to have my account charged once my Explanation of Benefits (EOB) reflects patient responsibility
-I prefer to wait 30 days until after my statement date to charge my account
If you elect the first choice, your card will be charged immediately upon our office receiving your EOB from your insurance company.
If you elect the second choice, we will send you out a statement as usual. If we do not receive payment within 30 days we will charge the card which is on file with us.
You may elect to have a copy of your receipt mailed or emailed to you.
Below is a copy of our EFT form, please bring this to your next appointment if you would like to keep a card on file to use on future statements
Electronic Funds Transfer Form