We are looking forward to your visit. Please print and complete the following new patient forms.
New Patient Information (Adults)
New Patient Information (Minors)
Authorization to Disclose Protected Health Information
Notice of Privacy Practices
Medical Records Release
DO NOT DELETE - Hidden
What is the Patient Portal?
The patient portal allows secure communication between you and Novi Dermatology and allows you to:
- View and update your health information
- Update your preferred pharmacy information
- Send Novi Dermatology a secure message
How can I pay my bill?
- Online: Credit card payments are accepted online. Follow the instructions under “Pay a Bill” at the top of this page. You will be directed to our secure online payment website. If using an HSA card, be sure you have the correct billing zip code. You can also log onto your Patient Portal to make a Credit Card Payment.
- Phone: Call us at 248-946-4787 to make a credit card payment.
- In Person: Visit us at Novi Dermatology (44000 West 12 Mile Rd, Suite 103, Novi, MI 48377) to make a payment in person (cash, check, or credit card).
- Mail: Please be sure to enclose your statement stub (top portion of your statement) and mail check or credit card payment to the payment address below. DO NOT MAIL CASH.
Novi Dermatology PLLC
PO BOX 775453
CHICAGO, IL 60677-5453
If you have billing questions, please call us at 248-946-4787.
How much is a late payment or returned check fee?
Payments not received after 30 days from the statement date will incur a late fee of $25 per 30 days late.
A fee of $35 will be assessed for each returned check.
What types of insurance do you accept?
We accept the following insurance:
- Blue Care Network: PCP referral is required
- Blue Care Network Medicare Advantage
- Blue Cross Blue Shield (BCBS)
- Cofinity Network
- Health Alliance Plan (HAP)
- Humana Medicare Advantage
- Multiplan / PHCS network
- Priority Health
- Smart Health
- Tricare Prime: PCP referral is required
- Tricare East: Tricare Select, Reserve Select, Retired Reserve
- Tricare for Life Medicare Supplement
- United Health Care
Please call us at 248-946-4787 for additional information. Some insurances (other than noted above) will require a referral from your Primary Care Physician (PCP).
What are your office hours?
Our office hours are as follows:
- Mon, Wed | 7:00 AM – 4:00 PM
- Tues | 7:30 AM – 4:30 PM
- Thurs | 7:00 AM – 4:30 PM
- Fri | 8:00 AM – 4:30 PM
- Sat (once a month) | 8:00 AM – noon
Please contact us to schedule an appointment.
Still have a question? Please contact us. Our staff is here to provide answers to any questions you may have.
44000 W. 12 Mile Road
Novi, MI 48377
Mon, Wed | 7:00 AM – 4:00 PM
Tues | 7:30 AM – 4:30 PM
Thurs | 7:00 AM – 4:30 PM
Fri | 8:00 AM – 4:30 PM
Sat (once a month) | 8:00 AM – 12 noon