Effective · September 17, 2026 · Updated · September 17, 2026
What a Good Faith Estimate is
A Good Faith Estimate is a written estimate of the charges you can expect for a planned visit with Gibran Shaikh, MD. It lists the visit type, the expected charge, and the billing reference for the service. It is an estimate of expected charges — not a bill, and not a guarantee of the final amount.
Who can receive one
- Patients who are not using health insurance for the visit (self-pay or cash-pay).
- Patients who have insurance but choose not to have the practice bill it for the visit.
- Anyone who asks for an estimate before scheduling — you do not need to book first.
When an estimate is provided
- On request, before you schedule or pay for a visit.
- After a qualifying self-pay visit is scheduled, in advance of the appointment.
- Again, updated, if the planned service changes before the visit.
Estimates are prepared by practice staff and delivered through staff-prepared written estimate delivered through the practice's secure patient channel. The practice records when each estimate was generated and when it was delivered. An estimate is never treated as delivered until delivery has actually taken place.
How the estimate relates to the planned service
The estimate covers the consultation itself. It does not include medication, pharmacy charges, laboratory testing, procedures, in-person care, or any future visit. Those are billed separately by whoever provides them. Level of service is determined after the visit based on documented complexity, so the billing reference on your estimate may differ from the code finally submitted.
Current expected charges
30 minutes directly with Dr. Shaikh
CPT reference: 99204
Level of service is determined after the visit based on documented complexity.
20 minutes directly with Dr. Shaikh
CPT reference: 99214
Level of service is determined after the visit based on documented complexity.
Prices shown here are the same prices shown on the pricing page.
What your written estimate includes
- Provider name — Gibran Shaikh, MD
- Practice name — Dermatologic Services, PLLC
- Practice contact information
- Your name
- The expected service and its duration
- The expected charge
- The applicable CPT reference, where it has been approved
- The date the estimate was generated
- The date and time the estimate was delivered to you
- Any additional disclosure the practice is required to include
Your rights regarding estimates
This Good Faith Estimate shows the cost of items and services that are reasonably expected for your health care needs for a self-pay telemedicine dermatology consultation with Dermatologic Services, PLLC. The estimate is based on information known at the time it was created and does not include items or services that may be recommended during or after your visit, such as prescription medications, laboratory testing, pathology, imaging, procedures, or care from another provider or facility. Those would be billed separately by whoever provides them. This estimate is not a contract and does not require you to obtain the items or services listed.
If the final charges are substantially different
You have the right to receive a Good Faith Estimate in writing at least one business day before your visit, and you may ask for one at any time before scheduling. If you are billed at least $400 more than this Good Faith Estimate, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process. You must start the dispute process within 120 calendar days of the date on your bill. Keep a copy of this Good Faith Estimate. For questions or a copy of your estimate, contact us at manager@dermatologicservices.com or 347-291-1877. For more information about your rights, visit www.cms.gov/nosurprises or call 1-800-985-3059.
General federal information about surprise billing protections and the estimate dispute process is published at cms.gov/nosurprises. That link is provided for reference only and is not legal advice from this practice.
Dermatologic Services, PLLC is a cash-pay (self-pay) practice. Fees are not billed to any insurance plan, and amounts paid are not applied to an insurance deductible. Patients enrolled in Medicare or Medicare Advantage are not able to book online and are asked to contact the practice so we can review the visit before any appointment is made.
How to request an estimate
Contact the practice directly and staff will prepare a written estimate at manager@dermatologicservices.com or 347-291-1877. Please do not include medical details, photographs, or medication information in a request — an estimate does not require them.