Insurance Coverage

At this time Stanton Lactation & Feeding Therapy is fee-for-service. Payment is due at the time of booking. Most insurance companies and plans will reimburse their clients for services they’ve paid for. We provide our clients with a “super bill” and any paperwork that may help get their out-of-pocket costs reimbursed. HSA and FSA payments are accepted.

Under the Affordable Care Act (ACA) in the United States, certain preventive services are required to be covered by most health insurance plans without cost-sharing. Lactation support and counseling, as well as breastfeeding equipment and supplies, are among the preventive services covered under the ACA. Coverage for lactation support and counseling, as well as breastfeeding equipment and supplies, is provided for the duration of breastfeeding.

It’s important for individuals to check the specific details of their health insurance plans to understand the scope and limitations of coverage for lactation services. Coverage may vary among plans, so it’s advisable to contact the insurance provider directly to obtain information about the services covered and any additional requirements.

Submitting a superbill:

Submitting a superbill to your insurance company is a process where you can seek reimbursement for the medical services you received as a self-pay patient. A superbill is a detailed invoice that includes the services provided, their costs, and any other relevant information that your insurance company may require.

To submit a superbill, you will need to follow these steps:

1. Obtain a copy of the superbill from our private practice. This document will include all the necessary information about the services you received, such as diagnosis codes, procedure codes, and the dates of service.

2. Contact your insurance company to inquire about their specific requirements for submitting a superbill. They may have different procedures or forms that need to be filled out.

3. Fill out any necessary forms provided by your insurance company. This may include attaching the superbill to the form or filling out an online reimbursement request.

4. Submit the completed forms and superbill to your insurance company. You may need to mail them or submit them electronically, depending on the insurance company’s preferred method.

5. Wait for the insurance company to process your claim. This can take some time, so it is important to be patient. The insurance company will review the superbill and determine the amount of reimbursement you are eligible for based on your plan’s coverage.

6. Once the claim is processed, you will receive an explanation of benefits (EOB) from your insurance company. This document will outline the amount they will reimburse you and any remaining balance that you may be responsible for.

It is important to note that not all insurance companies will reimburse you for self-pay services, and the amount of reimbursement can vary depending on your specific insurance plan. It is recommended to contact your insurance company beforehand to understand their reimbursement policies and any potential out-of-pocket costs you may incur.

We are happy to assist you with any questions or additional documentation you may need to submit to your insurance company. Please feel free to reach out for guidance and support throughout this process