When people hear "no insurance accepted," their first reaction is often concern. But after their first visit, almost every patient tells us the same thing: they wish they'd found us sooner. Here's why we made this choice — and why it benefits you.
What Is Direct Pay Dermatology?
Direct pay (also called direct care or cash pay) means patients pay directly for their care at transparent, published prices — without going through insurance. There are no insurance contracts, no prior authorizations, no billing departments, and no surprise explanation-of-benefits statements arriving weeks later.
You know exactly what you'll pay. Before you book, you can see our prices on our pricing page. There are no hidden fees, no facility charges, and no upcoding.
Why We Left the Insurance System
Dr. Sergay trained and practiced within the traditional insurance-based model before founding Sergay Dermatology.
- Insurance dictates which treatments are "approved" — often preferring cheaper, older options over newer, more effective ones
- Prior authorizations can delay treatment for weeks or months
- Patients often see a PA or NP, not the actual physician they thought they were booking
- Billing errors and surprise charges are common
By stepping outside that system, Dr. Sergay regained control over how she practices medicine.
What You Get With Direct Pay
- You always see the doctor. Dr. Sergay sees every patient. Not a PA, not an NP, not a medical assistant. The board-certified dermatologist — every single time.
- Longer appointments. No rushing. You have time to discuss your full history, ask questions, and develop a complete treatment plan — not just address the one thing that made it onto the chief complaint.
- No prior authorizations. If Dr. Sergay recommends a treatment, you can start it. No waiting for insurance approval.
- Transparent, fair pricing. Our prices are published on our website. A patient appointment is $195. A telehealth appointment is $175. Procedures have set prices with no add-ons.
- Best-in-class treatments. Our treatment decisions are based entirely on what works best for you — not what insurance will reimburse.
Is It Actually Affordable?
For many patients, yes — especially when you factor in the full cost of insurance-based care. Consider the typical insured patient experience:
- Insurance premiums: $400–$800/month
- Deductibles: $1,500–$5,000+ before insurance pays anything
- Copays: $30–$60 per specialist visit
- Surprise facility fees, lab fees, and more
If you haven't met your deductible (and most people haven't by February), you're often paying full cost anyway — just through a more complicated, opaque system. For dermatology specifically, most patients visit 2–4 times per year. The total direct-pay cost is often comparable or less than what they'd spend out-of-pocket through insurance.
We also provide superbills (itemized receipts with procedure codes) that patients can submit to insurance for potential out-of-network reimbursement or to apply toward their HSA/FSA.
A Model Built for Patients
At the end of the day, direct pay dermatology is about aligning incentives. In a traditional insurance practice, the doctor is accountable to the insurance company. In a direct pay practice, the doctor is accountable to you.
That's the model we believe in at Sergay Dermatology — and it's why we think our patients keep coming back.
