Lactation Support-Payment Policies
Self-pay (out-of-network) clients: I will provide you with a superbill suitable for you to submit to your insurance. The superbill (which will also serve as a payment receipt) will be coded appropriately to the level of service provided during the visit. You agree to pay me at the time of the visit (cash, check, credit card, or FSA). Lactation Network clients: Detroit Mama Hub LLC (business of Jalyn Spencer-Harris, IBCLC) partners with The Lactation Network/ Ashland Health to allow direct billing of services for some BlueCross BlueShield, Anthem, Cigna, PNOA, TLN, and United plans. Patients will submit their insurance information to be verified by The Lactation Network. If your insurance is approved, you will receive email verification for up to six visits. Pre-approved visits covered by insurance through The Lactation Network are at no cost to the patient. If your insurance company is not approved by The Lactation Network, you are considered a cash-pay patient and will be responsible for paying for all services out of pocket. Please see above for self-pay and superbill information. Insurance verification must be completed prior to your visit in order for The Lactation Network to verify your benefits and respond, this process takes less than 24 hours, emergent situations are handled in 3 or less hours. Upon insurance approval, you will be required to sign an Assignment of Benefits form with The Lactation Network to allow billing of your visit. If you do not complete the insurance verification process and do not submit an Assignment of Benefits prior to your visit, you will be responsible for paying out of pocket for your visit. Detroit Mama Hub is subcontracted by The Lactation Network for your lactation appointments. Detroit Mama Hub is not involved with your insurance verification or billing. If you have questions regarding insurance billing or verification, please email info@thelactationnetwork.com.
Aetna (in-network) clients: Claims for my care will be submitted directly to Aetna. Jalyn Spencer-Harris, IBCLC will appeal all cost-sharing under the Affordable Care Act which states that lactation services are preventive and not subject to cost-sharing. Every effort will be made to have my insurance recognize these claims as preventive and not subject to cost-sharing. If my insurance provider applies any portion of my claim to deductible or coinsurance, I understand that I am required by law to pay cost-sharing to Jalyn Spencer-Harris, IBCLC and I will be charged upon receipt of the Estimation of Benefits (EOB) by Jalyn Spencer-Harris, IBCLC and I agree to pay within 14 days for all applied charges for all visits. An appeal will be initiated by Jalyn Spencer-Harris, IBCLC and if appeal attempts are successful, I will be refunded any amount that Jalyn Spencer-Harris, IBCLC recovers from my insurer. If I have different primary insurance that is out-of-network for Jalyn Spencer-Harris, IBCLC, I understand that I must pay the full up-front self-pay fee.
Jalyn Spencer-Harris, IBCLC is providing care to me and to my baby or babies; together we are all the client of Jalyn Spencer-Harris, IBCLC. My initial visit includes 1 week of follow-up support by secure messaging, email, or text. If my location has a travel fee applied, I understand that this is not eligible for insurance reimbursement.
I am responsible to verify my own lactation benefits. Jalyn Spencer-Harris, IBCLC can only see that I have benefits, they cannot see if I have any special circumstances that might prevent my insurance provider from covering services. If my plan denies coverage of lactation services after the claims have been submitted, I am responsible to pay at the self-pay rate. I understand I should refer to my plan benefits and call my insurance directly to verify lactation coverage.Jalyn Spencer-Harris, IBCLC may communicate with my insurance company in reference to the services provided to me and my baby or babies.
Jalyn Spencer-Harris, IBCLC may communicate with my credit card company or bank for any payment related matters. It is my responsibility to provide accurate and current payment and insurance information. I will update my credit card information as needed and am responsible for any costs and fees associated with my failure to provide updated information.
These policies apply to the practice of Jalyn Spencer-Harris, IBCLC and its representatives. Payments may be made electronically using a credit card or fund transfer. I use SquareUp to process payments. SquareUp meets the high standards of HIPAA and the banking industry for security and privacy with regard to financial transactions. However, SquareUp may send, automatically or per your request, email or text message receipts that reveal personal health information such as the date and type of lactation visit. If you are not comfortable with this, payment may be made via cash or check instead.