Payment Policies - Aetna

Insurance (in-network) clients: Claims for my care will be submitted directly to Aetna. Shoreline 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, I will be invoiced and I agree to pay within 7 days for all applied charges for all visits.

No upfront cost is due at the time of the visit. Shoreline 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 Shoreline Lactation. I will be billed upon receipt of the Estimation of Benefits (EOB) by Shoreline 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 Shoreline Lactation recovers from my insurer.

If one of us (me or my baby) is on different insurance and therefore out-of-network for Shoreline Lactation, I agree to pay $250 per visit. 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 Shoreline Lactation, I understand that I must pay the full self-pay fee of $250 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 Shoreline Lactation​ receives payment directly from either insurance, and only for the specific amounts paid by my insurance(s). Shoreline Lactation may keep any amount paid by my insurance(s) over and above the deposit I paid.

Shoreline Lactation ​is providing care to me and to my baby or babies; together we are all the client of Shoreline Lactation. I am responsible to verify my own lactation benefits. Shoreline 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.

Shoreline Lactation may communicate with my insurance company in reference to the services provided to me and my baby or babies.  Shoreline Lactation may communicate with my credit card company or bank for any payment related matters.  It is my responsibility to provide accurate and current insurance information. Payments may be made electronically using Zelle, cash or check. These policies apply to Shoreline Lactation and its representatives.

Updated: November 2024