Payment Policy
 

Self-pay clients:

  • Great Start Lactation will provide you with a super-bill suitable for you to submit to your insurance after services are rendered for any reimbursement you are eligible for under the Affordable Care Act. The super-bill (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 Great Start Lactation at the time of booking. Please note that Great Start Lactation cannot guarantee reimbursement. I do not offer refunds for services rendered for any reason. I recommend that you call your insurance and ask about your coverage for lactation benefits with an out-of-network provider. I will do my best to help you get reimbursed, however it will be up to you to deal with your insurance company directly. Payments are made electronically using a credit card or fund transfer. Great Start Lactation uses SquareUp to process payment. SquareUp meets the high standards of HIPAA and the banking industry for security and privacy with regard to financial transactions.

  • There is a $75 cancellation fee for any reason when the appointment is cancelled within 24 hours of the scheduled visit. Cancelling within 1 hour of the scheduled visit or no show will result in a full charge for the consultation at the self pay rate. This cancellation fee will be charged on the credit/debit card on file.

  • Payment may be made by cash at time of service. Please note that Great Start Lactation does not carry cash and that exact amount is required.

  • PayPal, Venmo or Zelle are not methods of payment that comply with HIPAA regulations and therefore are not accepted.
     

The Lactation Network clients:

  •  Great Start Lactation has partnered with Lactation Network to have lactation services covered by the insurance.  In-office visits are covered at 100%. If you prefer an in-home consultation a $65 travel fee will apply. This travel fee is not covered by the insurance nor Lactation Network.

  • There is a $75 cancellation fee for any reason when the appointment is cancelled within 24 hours of the scheduled visit. Cancelling within 1 hour of the scheduled visit or no show will result in a full charge for the consultation at the self pay rate. This cancellation fee will be charged on the credit/debit card on file. You agree that Great Start Lactation provides Protected Health Information to Lactation Network including but not limited to intake and medical history, plan of care, provider report(s).

Aetna clients:
 

  • Great Start Lactation is in-network with Aetna, which means Great Start Lactation will submit your fees for Aetna’s consideration. Aetna’s usual and customary allotment for each procedure will satisfy your account; ultimately, each client remains responsible for full payment for services. You are responsible for providing Great Start Lactation with accurate insurance information and informing Great Start Lactation of any changes in your insurance status; if you do not have coverage at the time Odelia Marciano, IBCLC sees you, you will be responsible to pay Great Start Lactation at the self-pay clients rate.

    In the following section, "I" is referred to the client/patient.

     

  • I understand that I am responsible for all charges associated with this visit. If I cancel with less than 24 hours notice for any reason, my credit card on file will be charged $75. Cancelling within 1 hour of the scheduled visit or no show will result in a full charge for the consultation at the self pay rate.

  • Claims for my care will be submitted directly to Aetna. Great Start Lactation will appeal all cost-sharing under the Affordable Care Act which states that lactation services are preventive and not subject to cost-sharing. If my insurance provider applies any portion to deductible or coinsurance and appeal attempts are unsuccessful, my credit card on file will be charged. If that charge is unsuccessful for any reason, I will be invoiced and I agree to pay within 7 days for all applied charges for all visits.Great Start Lactation will submit a claim on behalf of myself and my babies. If any portion of either claim is applied to cost-sharing, I understand that I am required by law to pay cost-sharing to Great Start Lactation. My credit card will be charged upon receipt of the Estimation of Benefits (EOB) by Great Start Lactation. Every effort will be made to have my insurance recognize these claims as preventive and not subject to cost-sharing, and an appeal will be initiated. If successful, I will be refunded any amount that Great Start Lactation recovers from my insurer.

  • If one of us (me or my baby) is on different insurance and therefore out-of-network for Great Start Lactation​, I agree to pay the self-pay clients rate per visit. If only my baby is on a different insurance at the time of the visit, I agree to pay $71.50 for the portion of the visit dedicated to baby. I will receive a superbill for this amount and can submit for out-of-network insurance. 

  • If I have different primary insurance that is out-of-network for Great Start Lactation​, I understand that I must pay the full self-pay fee up front as a deposit. I will not be refunded for any amount either insurance applies to cost-sharing. I will only be refunded if and when Great Start Lactation​​ receives payment directly from either insurance, and only for the specific amounts paid by my insurance(s). Great Start Lactation​ may keep any amount paid by my insurance(s) over and above the deposit I paid.

  • Great Start Lactation ​​is providing care to me and to my baby or babies; together we are all the client of Great Start Lactation.
    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. If I request a home consultation and my home location is outside of the 5 miles radius of Great Start Lactation office located in Los Angeles 90048, a travel fee of $65 will apply and the credit card on file will be charged after the appointment. I understand that this travel fee is not eligible for insurance reimbursement.

  • I am responsible to verify my own lactation benefits. Great Start Lactation​ 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.

  • Great Start Lactation ​may communicate with my insurance company in reference to the services provided to me and my baby or babies.  Great Start Lactation​ 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 Great Start Lactation​ and its representatives.