Bayou City Breastfeeding Payment Policies

NOTICE OF PAYMENT POLICIES 

Effective Date: June 8, 2024

THIS POLICY DESCRIBES OUR PAYMENT POLICIES. PLEASE REVIEW IT CAREFULLY.

 

Notice of Payment Policies

This document outlines the payment policies of Bayou City Breastfeeding. We strive to provide clear and concise billing practices to ensure a seamless and transparent client experience.

 

Self-Pay (Out of Network) Clients:

BCB will provide a superbill for you to submit to your insurance for potential reimbursement. While we do not guarantee reimbursement, we require that a valid credit card be kept on file. Charges for services rendered will be processed within 2 business days of the visit. A timely payment discount is available for payments made within this period.

 

Insurance Billing for Parent and Child:

BCB values the health of both mother and baby, considering both as our clients. When using insurance benefits, we will submit claims on behalf of both. However, if one party is on a different insurance plan and out of network for BCB, the applicable out-of-network fee will be charged per visit.

 

Updated Policy for Specific Insurance Plans:

Due to recent changes by certain insurers, BCB cannot bill lactation claims for both mother and baby on the same date of service for the following plans:

  • Blue Cross Blue Shield (BCA, BFT, and BCF Plans)
  • Cigna through Wildflower
  • Tricare

To manage these changes, BCB will implement a per visit fee for the baby’s portion of the claim:

  • Initial Visits and Visits 90 Minutes or Longer: $60
  • 1-Hour Visits: $50
  • 30-Minute Visits: $40

These fees are collected at the time of service to cover the portions not billable due to the restrictions imposed by these insurance providers.

 

Cost Sharing and Copays:

We are required to collect any copay, coinsurance or deductible applied by your insurance company.

  • Expected cost-sharing amounts are collected upfront, and appeals will be filed on your behalf if applicable.
  • For ACA-compliant plans, lactation services are considered preventive and are not typically subject to cost sharing for the mother. However, some plans may apply cost sharing for services related to the baby.
  • Non-ACA compliant plans should expect to have cost-sharing and if amounts are not collected upfront, they will collected upon receipt of the EOB.

 

Travel Fees:

Travel fees are not eligible for insurance reimbursement. If a claim including a travel fee is submitted, it may be denied, and you will be liable for the full self-pay fee.

 

Verification of Benefits:

Clients are responsible for verifying their own lactation benefits. It is crucial to ensure that our services are covered under your specific plan, including any special circumstances or restrictions.

 

Claim Denials:

If your insurance denies a lactation service claim, you will be required to pay the self-pay rate. Payment within 2 business days qualifies for a timely payment discount.

 

HIPAA and Communication:

BCB will communicate with your insurance regarding services provided and may release information as necessary to support insurance claims processing.

 

Contact Information:

For any inquiries or further clarification on our policies, please contact our billing department at 281-626-5271 or via email at [email protected].

 

These policies apply to Bayou City Breastfeeding LLC, its representatives, and employees. A copy of these policies will be provided upon request.