Payer advocacy

The Academy works with private payers to alleviate administrative burdens for dermatologists, maintain appropriate reimbursement for furnished services, and ensure patients can access covered quality care.

The Academy builds relationships with public and private payers and examines coverage and payment trends affecting dermatology.

This critical collaboration addresses immediate needs affecting our members’ ability to deliver care, such as when policy changes affect claims and formulary coverage or payment. Our coordinated strategy ensures payer policies align with everyday practice for dermatologists, so they can focus on treating patients.

The Academy meets regularly with the largest health plan carriers including Aetna, Elevance Health (formerly Anthem), UnitedHealthcare, and Cigna. These regular, ongoing contacts address priority dermatology payment issues. Additionally, the Academy works with state dermatology societies as needed to address local and regional payer issues.

Priority payer advocacy issues

• Modifier 25 payment reductions

• E/M downcoding

• Prior authorization

• Immunohistochemistry (IHC) Policy