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Patient Information

New Patient Forms

Innovative Dermatology, PA requests that all new patients provide us with basic health and general information, as well as any previous dermatologic history.

Please print and complete the following forms and bring them with you on your scheduled visit to our office. Thank you for your cooperation.

New Patient Information and Forms Packet

Other Forms

New Patient Information and Forms Packet


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Insurance and Billing

Innovative Dermatology, PA is pleased to participate as an in-network provider with several major health insurance plans. If we are in the network of your insurance carrier, we will file medical claims directly for you. To submit your claim, we must have a current copy of your insurance card on file. While we file your claims for you as a courtesy, please be aware that payment for services remains your responsibility. Please note that benefits provided by your insurance company may vary based on your specific plan benefits. Our practice also welcomes self-pay patients. Please contact us for additional information.

In general, we are unable to provide accurate quotes for surgical procedures and other medical skin procedures in advance of your date of treatment. We make every attempt to verify your insurance benefits in advance, but ultimately it is your responsibility to know your own insurance benefits and how they can apply to services rendered. This is included, but not limited to, copays, deductibles for procedures, coinsurances, health savings account benefits, and pharmacy or prescription benefits. Upon request, we can attempt to provide with you a quotation, but many times this will not be an accurate representation of how your insurance will process your claim, and our practice is in no way responsible for any discrepancy if you request a quotation. It is always best, and ultimately your responsibility as a patient and policy holder, to contact your insurance carrier directly as we do not have access to the exact details of your personal insurance policy.

Accepted Insurance

Below is a list of insurance plans we accept. Please contact our office if your insurance plan is not listed below:

  • Medicare (including all Medicare Advantage Plans)
  • Aetna
  • Aetna Medicare Advantage
  • Averde
  • BeechStreet PPO
  • Cigna (Specific plans only. Please verify with Cigna first.)
  • Coventry/First Health Network
  • Coventry Advantra MA PPO
  • First Health (CCN)
  • HealthSmart (Accel/GEPO/PPO/POS)
  • HMO Blue Texas
  • Humana Choice Care
  • Humana MA PFFS
  • Humana Medicare HMO
  • Humana Medicare PPO
  • Interplan Health (IHG)
  • Secure Horizons
  • Texas True Choice
  • United HealthCare
  • Tricare (Specific plans only. Please verify with Tricare first.)
  • PHCS/Multi-Plan

Referral Form

Dr. Seemal R. Desai welcomes referral and consultation requests from physicians and providers of all specialties. Feel free to use the form below to help make your request easier. As an alternative, please simply call our office, and our staff will be more than happy to help you get your patient scheduled.

New Patient Information and Forms Packet


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Patient Portal

Here is the link to go to the Patient Portal: