Payment Options
INSURANCE
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Dr. Schecter is IN-NETWORK with the following insurance plans. IN-NETWORK claims will be submitted directly on your behalf.
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AETNA (excluding Aetna Better Health/Aetna Medicaid plans)
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MERITAIN (managed by Aetna)
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Please note that Breastfeeding Medicine consultations and tongue tie consultations involve both the lactating or bottle feeding parent and baby. One claim will be submitted for the parent, and a separate claim will be submitted for the child.
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If parent and child are covered by different insurance policies, please inform the office so that we submit your claims properly.
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If only the baby is covered by an in-network insurance plan, there will be a separate lactation fee for the parent. An insurance claim will be provided to submit for reimbursement.
Payment is collected at the time of service for any anticipated member responsibility (copay, co-insurance, deductible).
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** Please note that Aetna has recently stopped reimbursing us for PHYSICIAN-LEVEL evaluation and management services, which is precisely the level of care patients seek when they come to our office.
Aetna (and their subsidiaries) are only covering general IBCLC-level lactation services. Representatives have continued stating that they will cover the service codes, but later deny coverage or take back their payments. Unfortunately, we have found no good solutions for this very real insurance benefit coverage problem. In order to be fairly reimbursed for providing PHYSICIAN-LEVEL care, we may assess a physician-level fee. This fee may be applied to breastfeeding medicine visits, prenatal and induced lactation visits, and tongue tie visits for adults and children (>12 months of age or not breastmilk feeding). This fee is not reimbursable by insurance and will not be included on your insurance claim forms. It can be paid using your FSA or HSA plan.
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REFERRALS
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If your insurance plan requires referrals, you will need to request separate referrals for both parent and baby in advance of the visit.
NO SHOW AND LATE CANCELLATION FEE
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Please note that new patient appointments that are missed or cancelled with less than 24 hour notice will incur a fee of $75.
SELF-PAY
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We are pleased to offer the following PROMPT PAY DISCOUNTS for payment in full at the time of service:
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FRENOTOMY CONSULTATIONS (tongue, lip, and/or cheek ties)
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Frenotomy Appointments (tongue, lip, and/or cheek ties): $665. This includes the consultation, all releases, and feeding support immediately afterwards, as needed.
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Tongue Tie Consultation ONLY: $220. If an assessment is performed, and a release is not needed or recommended at the initial consultation. This appointment does not include lactation support.
BREASTFEEDING MEDICINE CONSULTATION: $420
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* Out of network benefits will apply. You will be provided with a claim to submit for reimbursement.
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* If you would like to contact your insurance company in advance regarding coverage of benefits, you will be asked to provide billing codes. The diagnosis codes used for tongue tie are: p92.5 and q38.1. The procedure code for frenotomy is 41010.
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NO SHOW AND LATE CANCELLATION FEE
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Please note that new patient appointments that are missed or cancelled with less than 24 hour notice will incur a fee of $75.