For our convenience and yours, we ask that each potential client completes all forms available on the Patient Login section. This will speed up the initial patient entry before your first office visit. Please complete all pages on the Patient Login at the top right of the screen. If you do not have a security code, please contact our office at 504-455-9933. Please bring your Insurance Card and Picture ID to your appointment.
If you are unable to complete your medical history online before your appointment you may print out the registration forms below to bring with you.
After your visit with the Physician or Physician Assistant you are eligible for the following
(must be 18 years or older)
- Complimentary Visia (Computerized Skin Analysis) – Become aware of sun related changes in your skin
- Complimentary 10% TCA peel with Aesthetician
- Complimentary skin care evaluation with Aesthetician. Please bring in a list of your daily skin care products
Cancellation & Appointment Policy
If you do not cancel your appointment at least 24 hours in advance or if you no show, you will automatically be billed a $50.00 charge for dermatologist appointments or a $100.00 charge for scheduled procedures and injectables.
Procedures Covered By Insurance
If your health insurance requires a referral to a specialist office, please contact your primary care physician to set up the referral prior to your appointment. We will contact your insurance carrier after your visit for any necessary authorizations. A co-payment will be collected at the time of your visit.
Payment is expected at time of service. We accept cash, credit, VISA, MasterCard and Discover. We do not accept American Express. Payment will include any unmet deductible, co-insurance, co-payment amount or non-covered amount from the insurance company. If you do not have insurance, payment is due at time of service.
Bopp Dermatology & Facial Plastic Surgery is a participant in many Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). We automatically file claims for all insurance companies. Because insurance coverage can vary from plan to plan, please understand that you are ultimately responsible for settling your account.
Return checks will incur a $25.00 service charge. You will be asked to bring cash, certified check or money order to cover the amount of the check and the service fee. All bad checks written at the office are subject to collection action and will be prosecuted by Jefferson Parish District Attorney’s office.
Form Fees & Medical Records require a pre-payment for the completion of these forms. Charge is determined by the number of pages that are copied.
Brilliant Distinctions Program
Brilliant Distinctions is a loyalty program where you can earn points redeemable for dollars off treatments of Botox Cosmetics and/or Juvederm XC Injectable Filler. Make sure to register before your appointment so you can begin earning points on your next visit. You can register at www.brilliantdistinctions.com.