Self-pay (out-of-network) clients:
Westchester Lactation will provide you with a superbill suitable 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 Westchester Lactation the listed fees via credit card or FSA at the time of booking.
Insurance (in-network) clients:
Dana Hilsenrath, IBCLC, of Westchester Lactation is in-network with Aetna, Claims for care will be submitted directly to Aetna for consideration. Aetna’s usual and customary allotment for each procedure will satisfy your account; ultimately, each client remains responsible for full payment for services. If Aetna applies any portion of the fees to deductible or coinsurance, your credit card on file will be charged. If that charge is unsuccessful for any reason, you will be invoiced and agree to pay within 7 days for all applied charges for all visits.
A claim will be submitted for the care of you and your baby/babies. If any portion of your baby’s claims are applied to cost sharing (ie. deductible or coinsurance), you will be invoiced for those charges. Your credit card will be charged upon receipt of the Estimation of Benefits (EOB) by Westchester Lactation.
If your baby is not on your Aetna plan, you agree to pay $60 for the initial visit and $40 for any follow up visits, in addition to any cost sharing for which you are responsible. You will receive a superbill for this amount and can submit for out-of-network insurance. You are responsible for providing accurate insurance information and informing Westchester Lactation of any changes in your insurance status; if you do not have coverage at the time of your lactation consultation, you will be responsible to pay for your service at the listed self-pay rate. If your plan denies coverage of lactation services after the claims have been submitted, you are responsible to pay at the self-pay rate. PLEASE NOTE: There is a possibility that the claim filed for your baby will be subject to cost sharing.
For Aetna clients only, a $50 convenience fee will apply for all in-home visits. This fee is not reimbursable by Aetna and is charged to the client directly when the appointment is booked. This does not apply to virtual visits.
Westchester Lactation is providing care to you and to your baby or babies; together you are all the client of Westchester Lactation.
Westchester Lactation may communicate with your insurance company in reference to the services provided to you and your baby or babies.
SquareUp: Payments may be made electronically using a credit card or fund transfer. Westchester Lactation uses 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.
Cancellation policy: I understand that I am responsible for all charges associated with this visit. If I cancel with less than 24 hours notice, my credit card on file will be charged $50.
WIC Policy: A discount is available for WIC participants. Westchester Lactation reserves the right to limit the amount of discounted appointments that are available.
Travel Policy: A surcharge will be applied to home visits outside of the designated service area. Appointments outside of this service area may be made available at Westchester Lactation’s discretion. This surcharge is not eligible for insurance reimbursement.
These policies apply to Westchester Lactation and its representatives. All services are non-refundable.