Home visit convenience fees are not eligible for insurance coverage reimbursement.

We cannot guarantee that your covered services will not have cost-sharing applied by your insurance. 

Even if your insurance told you that you have full coverage for lactation care, there will likely be limitations and restrictions on care that may differ from plan to plan. 

We cannot legally or contractually waive the cost-sharing under any circumstance. We are required by law to invoice you.

We submit a claim for you and for your baby (when present). That is two separate claims for two separate people.

You and your baby do NOT need to be on the same insurance for services to be rendered.

If one of you is out-of-network, we will still submit an out-of-network claim to the insurance in the hopes that they will pay something.

Once both of your claims have been processed, we will balance bill you for any amount not covered by either insurance up to our listed self pay fee for the type of visit you had. We will never charge you any amount that would cause us to collect more than our stated self pay fee from you and your insurance combined.

Any cost-sharing above $100 entitles you to one week of follow up messaging support, to begin upon receipt of payment.

Example 1: The self pay fee for the service is listed as $200. We bill each insurance $200. Your in-network insurance pays $100. Your baby’s out-of-network insurance pays $10. You would be balanced billed $90.

Example 2: The self pay fee for the service is listed as $200. We bill each insurance $200. Your baby’s in-network insurance pays $100. Your out-of-network insurance pays $200. You would not be billed anything.

We are in-network with Aetna and most Aetna subsidiaries: Meritain, Nippon Life, and GEHA. We are out-of-network for 1099.

If you would like a home visit, you will pay a convenience fee of $75 for each visit. The home visit convenience fee is non-refundable if you cancel with less than 24 hours' notice.

We cannot guarantee that your covered services will not have cost-sharing applied by your insurance.

Aetna may have told you that you would get up to 6 “free” lactation sessions. They probably did not also explain to you that they place strict limitations on what those free sessions actually include.

This is going to get a little technical, so bear with me. 

There is a code called S9443 which covers a lactation session  by a non-physician provider. Aetna gives you 6 uses of this code (per delivery or child, calendar year, what frequency?). Services that we offer which are fully covered by this code include:

• Virtual prenatal 

• Virtual check in for existing clients

• In office prenatal

• In office flange fitting

In order to provide comprehensive lactation care for you and your baby, we bill S9443 for you and for your baby. The reason we bill S9443 for both you and your baby is because it will not count to anyone’s deductible. It allows us to receive payment and minimize or even eliminate potential out-of-pocket costs to you. 

But since you only get 6 uses of S9443, that code does run out. After six uses of this code, Aetna will tell you that S9443 is now “patient responsibility.” You will be responsible for any amount applied to your deductible, and balance billed up to our published self pay rate for the type of appointment you had on that date of service (initial, follow up, or prenatal, in office, home, or virtually). 

In addition, we bill time-based codes that cover the additional time required to provide comprehensive care. We will tell you in advance if any of these codes might have cost-sharing. 

You will be invoiced for cost-sharing and your card on file will be billed. We will be checking your benefits prior to each visit so that we can alert you about what this might be. 

Complete payment policies will be provided on booking.

Contact us before booking if we are in-network with your baby's insurance but out-of-network for yours, and we will advise on how to book.

We are in network with most commercial plans: BLUE ACCESS, EPO, HMO, INDEMNITY& PPO. We are likely out of network if you purchased your plan on the marketplace, but we can check. We do not accept Medicaid.

If you would like a home visit, you will pay a convenience fee of $75 for each visit. The home visit convenience fee is non-refundable if you cancel with less than 24 hours' notice.

We cannot guarantee that your covered services will not have cost-sharing applied by your insurance.

Complete payment policies will be provided on booking.

Contact us before booking if we are in-network with your baby's insurance but out-of-network for yours, and we will advise on how to book.

We are in-network with CIGNA as of 12/1/2024 and can bill them directly.

We are in-network with commercial plans through UnitedHealthcare Insurance Company and its affiliates. We are out-of-network for Oxford Liberty, Medicaid, and Essentials plans.

United Healthcare only covers in-person lactation care.

If you would like a home visit, you will pay a convenience fee of $75 for each visit. The home visit convenience fee is non-refundable if you cancel with less than 24 hours' notice.

Complete payment policies will be provided on booking.

Contact us before booking if we are in-network with your baby's insurance but out-of-network for yours, and we will advise on how to book.

Up-to-date fee information is available in the online booking widget.

We will provide you with a superbill coded under the lactating parent that includes the insurance information you provide to us. We cannot guarantee that your insurance will reimburse you under the Affordable Care Act.

Sliding scale may be available if you or your partner(s) meet one of these qualifications: on WIC, on Medicaid, DOE teacher, or unemployed.

Please contact us prior to booking to request sliding scale.

Contact us before booking if we are in-network with your baby's insurance but out-of-network for yours, and we will advise on how to book.

Sliding scale may be available if you or your partner(s) meet one of these qualifications: on WIC, on Medicaid, DOE teacher, or unemployed.

Please contact us prior to booking to request sliding scale.