FAQs
Important Message for Aetna Policy Holders
A new year means insurance policies will be starting over! That means that deductibles will be also be starting over. You may see cost shares apply for some of your visits.
If you are a current patient and your insurance has changed since your last visit – please let us know asap! This will most likely impact your coverage.
We collect cost shares per our financial policy. Our financial consent form is part of every visit intake form and must be signed before we meet with you. Please take the time to read through these policies before you agree to them.
Historically, co-share amounts decrease in time as you pay deductibles on other medical bills.
Despite how it is explained to you by your insurance company, lactation healthcare is not a free service and cost shares may apply according to your specific insurance policy.
If you have more questions, please read the Q& A below. We are also happy to answer any questions you may have before booking your visit.
We look forward to supporting you in 2024! Thank you for trusting us with your care.
What are your rates?
Our 2024 private pay rates are as follows:
PRENATAL VISITS
Home $175 (+ travel fee)
Office $175
Virtual $175
INITIAL VISITS
Home $350 (+ travel fee)
Office $350
Virtual $300
FOLLOW UP VISITS
Home $300 (+ travel fee)
Office $300
Virtual $250
PUMPING/BACK-TO-WORK/WEANING
Home $225 (+ travel fee)
Office $225
Virtual $175
* Packages Available
* Sliding Scale for WIC & MEDICAID Recipients Available
Do you accept insurance?
We are in network with Aetna & United Healthcare.
We are considered OON ( out of network) providers for all other insurances at this time. You have the option to self pay and submit for reimbursement. We DO NOT guarantee reimbursement but we can submit a claim on your behalf for a fee of $50 per claim.
I called Aetna and they said I am covered 100% for lactation visits. Does that mean I have 6 “Free Visits”?
No, and not always at 100%. Lactation Healthcare is not a free service and insurance coverage is generally misunderstood and not explained properly.
Why did Aetna say I have 6 Free Visits? Is anything guaranteed to be covered 100%?
Yes, Aetna guarantees 100% reimbursement for code (S9433) for a 60 minute visit, for 6 visits at 100% in a 12 month time period. The 12 month window begins with your first visit. Those do not renew at the start of a new year. This is mandated through the Affordable Care Act.
Every insurance company, their subsidiaries and each benefit plan is different. It is important to understand the specific terms of your coverage.
A variety of billing codes are used per claim based on several factors pertaining to each visit: participants being evaluated or assessed ( mom only vs. mom & baby), visit duration and visit complexity. We do not know in advance every code that will apply to your visit(s).
After 6 visits in a 12 month period, Code S9433 (Lactation class) – runs out. But most often, Aetna will continue to pay providers on other codes. That means that cost sharing is applied for Code S9433 code for mom and for baby after visit 6.
In most cases, Aetna is reimbursing providers fairly based on insurance policy benefits per family and the contracted fee schedule between provider & insurer. It is the cost sharing piece that surprises most families because they are told that they get “6 FREE VISITS”. That wording is deceptive and not accurate.
I just had a baby but they will not be added to our Aetna policy before our consultation. Can we still meet with you?
Yes. The process to add your baby to your Aetna policy can take a few days up to a few weeks. You can still meet with us before that happens. Once your baby is added, we will bill for your baby’s portion of the visit. It is important to communicate with us if your baby’s PRIMARY POLICY is not Aetna.
What do I do if my baby’s primary insurance is not Aetna?
You are responsible to complete a coordination of benefits form. If your baby’s primary insurance does not cover your baby’s portion of your visit, you are financially responsible for that portion of the visit.
Do you guarantee reimbursement for self pay visits?
No, we cannot guarantee that you will be reimbursed. We will provide you with a super bill and paid receipt for services rendered for you to submit to your insurance company. Reimbursement is dependent upon your insurance company and your policy’s benefits but you will not be reimbursed at all if you do not have OON (Out of Network) LACTATION benefits. If you do have OON LACTATION benefits, there is a much greater chance of being reimbursed.
Can your billing department help me submit for reimbursement to my insurance?
Yes. If you choose to have Little Bean Lactation submit for reimbursement on your behalf, there is a $45.00 fee for this service. This does not guarantee reimbursement but this does remove the hassle of dealing directly with your insurance company.
What types of consultations do you offer?
Please see the “Services” section of our website to understand more about our consultations.
What types of visits do you offer?
Office, Home & Virtual
Where is your office?
318 Main Street, Suite 101C, Millburn, NJ
Do you have a waiting room?
Yes, it is a shared waiting room with 3 other practitioners. There is comfortable seating for 2 people and room for a stroller.
Can I feed my baby in your waiting room if necessary?
Yes
Is there parking available near your office?
Parking is right in front of our building and there are always spots available.
Can I bring someone with me?
Yes, you can bring a support person with you to your visit.
What do I need to bring to my visit?
You will receive an email with instructions for your visit after your appointment booked and confirmed online.
How do I book an appointment?
Click on the “Book Your Visit” Button
Do you charge my credit card on file?
No. This is not charged at the time you book your visit. Your credit card is used to secure your visit and is only used if you are a self pay patient – or – if your insurance company has determined you have a co-pay -or- your policy does not cover the entirety of your visit. If this occurs, we will invoice you first. Payment is due upon receipt. If your invoice is not paid within 7 days of issuance, we will process the invoice, using the card on file that you provided. This is part of your consent for care policies in your intake forms.
Do you charge a travel fee for home visits?
Yes. Our home visit travel fee is dependent upon your location. Please inquire about fees for your area by texting 973-935-3230. In general, our home visit specialist does not travel further then 20 mile radius of the Millburn, NJ area.
Do you work with bottle feeding families or families who choose to not directly breast or body feed?
Yes, absolutely.
Are you an inclusive practice?
Yes, absolutely.
Do you have training in Lip, Tongue & Cheek Tie Assessments?
Yes, our team is well trained in TOTs and their impact on infant feeding. We are fully trained in functional feeding assessments, structural assessments and the facilitation of the post frenecotmy process.
What if I need to change or cancel my appointment?
Please notify us as soon as possible. We understand that life with a new baby is unpredictable and we are reasonable people but we do ask for us at least 12 hours notice. No shows and late cancellations will be charged a fee. This is outlined in your consent for care which are part of your intake forms. Rescheduling your visit is always an option.
What if I am running late?
How do I time my baby’s feeding for our consultation?
Think about your baby’s most recent feeding routine, and try to plan for a visit time that falls in between or after a feeding. We understand that this doesn’t always work – and that your baby might need to eat right before we meet. We do what we can to work with your baby’s needs.
What if my baby needs to eat right before our consultation?
Don’t withhold a feeding. It is better to Feed your baby something if they need to eat, even if the timing doesn’t work perfectly for your scheduled visit. Often times, offering a partial feeding to keep your baby comfortable works. We work with your baby’s schedule the best that we can.
Do you require masks?
Should I keep my appointment if one of us is sick?
No, we ask that you reschedule or opt for a virtual visit in place of a face to face visit.
