Terms and Conditions of Payment for Services:
I understand that Carol Kidd, IBCLC of Connections Lactation Care (CLC) is providing a professional service in my home and that I am responsible for all charges associated with this visit and future visits. Carol Kidd, IBCLC of CLC is providing care to me and to my baby or babies; together we are the client of Carol Kidd, IBCLC of CLC.
If I am using my insurance, claims for mine and my baby's or babies' care will be submitted directly to Aetna, or Banner Aetna. If my insurance provider applies any portion to deductible or coinsurance, I will receive an invoice for the remaining amount owed. If the invoice is not paid by the due date, my credit card on file will be charged for all applied charges for all visits.
Even if I believe my insurance should pay, I must pay the invoice and I will be reimbursed if and when my insurance does pay, up to the amount I paid.
Carol Kidd, IBCLC of CLC will allow 60 days for my insurance to pay my claims. After 60 days, claims will be considered denied, and I am responsible to pay at the self pay rate. If and when my insurance does ever pay, Carol Kidd, IBCLC of CLC will reimburse me up to the amount I paid.
If my baby is on different insurance or doesn't have insurance and therefore is out-of-network for Carol Kidd, IBCLC of CLC, I agree to pay $50.00 per visit for the baby as a cash client.
If I have different primary insurance that is out-of-network for Carol Kidd, IBCLC of CLC, I understand that I must pay the full self-pay fee up front as a deposit. I will be refunded if and when Carol Kidd, IBCLC of CLC receives payment directly from either insurance up to the amount I have paid.
I am responsible to verify my own lactation benefits. Carol Kidd, IBCLC of CLC cannot confirm my coverage. 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.
If any of my coverage is denied, it is up to me to communicate with my insurance company. Carol Kidd, IBCLC of CLC will not call on my behalf to appeal denials and poorly paid claims.
If my insurance provider is out of network for Carol Kidd, IBCLC of CLC, I will receive an invoice for the self-pay amount which is payable at the time of service. My paid invoice will serve as my super bill which I can submit to my insurance provider for reimbursement.
Alternatively, Carol Kidd, IBCLC of CLC can submit claims on behalf of myself and my babies for a fee of $20 to be added to my invoice upon request. I will be refunded any amount that Carol Kidd, IBCLC of CLC recovers from my insurer up to the amount I paid for the visit.
If I am using coverage through TLN, I understand that all financial correspondence is between myself and TLN. Carol Kidd, IBCLC of CLC is a contracted provider and is paid directly by TLN, and is not involved with the insurance coverage or billing.
If I cancel with less than 24 hours notice, my credit card on file may be charged $50.
If my location has a travel fee applied, I understand that this is not eligible for insurance reimbursement. Carol Kidd, IBCLC of CLC will charge $50, payable upon receipt of invoice, for any visit that is further than 40 minutes from the business address.
Carol Kidd, IBCLC of CLC, and billers working on her behalf, may communicate with my insurance company in reference to the services provided to me and my baby or babies. Carol Kidd, IBCLC of CLC 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 Carol Kidd, IBCLC of Connections Lactation Care and its students, interns, billers, or representatives.