Scheduling & Arrival Time
For office consultations, please plan to arrive at or just before your scheduled appointment time. If you have any challenges finding our office please call 206-973-0337.
For in-home consultations, please plan for your consultant to arrive within a 30-minute window around your selected appointment time in order to account for traffic or other unavoidable delays. For example, your consultant may arrive between 1:45 and 2:15 for a 2:00 appointment.
For phone consultations and coaching sessions, you will receive a call at the contact number your provide within a 10-minute window around your selected appointment time. For example, your call may begin between 1:55 and 2:05 for a 2:00 appointment. Calls will include up to the total number of minutes scheduled. If at the end of that time you want to continue the call and the consultant/coach has availability, you will decide to continue and be sent an invoice for additional pro-rated minutes.
Since January 1, 2014, and the implementation of the Patient Protection and Affordable Care Act, most insurance policies are required to cover certain preventive health services and screenings without subscriber cost-sharing. These include lactation support and supplies. (Exceptions to this include being on a “grandfathered in plan” or Medicare/DSHS.)
Sound Beginnings contracts with independent lactation consultants who are International Board Certified Lactation Consultants (“IBCLCs”) and RN IBCLCs, including some who are in-network with Aetna insurance.
Sound Beginnings recommends all clients contact their insurance prior to scheduling an appointment to determine their individual level of coverage and/or reimbursement for lactation services. For Aetna members: Most members are entitled to at least six (6) lactation consultations with no out-of-pocket costs; some plans or codes will require a co-pay or specialist co-pay, or coinsurance payment. At the time of booking, please request an IBCLC who is in-network with Aetna.
For all other insurance plans, Sound Beginnings’ independent lactation consultants are considered “out-of-network” for lactation services. Out-of-network providers are not typically fully covered by your health plan so you are often responsible for greater cost-sharing or even the entire cost of the visit. You should contact your insurance company to verify your benefit coverage and cost-sharing for an out-of-network lactation consultant. If your insurance company and policy are required to follow the ACA guidelines and they don’t have any lactation consultants in-network, they may be required to cover services from an out-of-network provider without cost-sharing. This is sometimes referred to as “gap coverage.”
For more information, the National Women’s Law Center has a very helpful toolkit and a Sample Letter for Lactation Consultant Coverage that can be downloaded and used to support your efforts for coverage.
Payment for Services
All clients agree and accept payment responsibility for the lactation consultation services regardless of outcome, insurance coverage, or other third party involvement.
For Aetna clients, we will file your claim with Aetna and invoice you for any copay or coinsurance after the claim is processed. You agree to pay any invoice promptly, no more than fourteen (14) days after you receive it. At the time of booking, please select an Aetna Lactation Consultation in order to request an IBCLC who is in-network with Aetna.
For non-Aetna clients, payment for a consultation is due at the time of booking through this online scheduling system. Sound Beginnings accepts all major credit cards. If you have a Health Saving Account (HSA) or Flexible Spending Account (FSA), lactation consultation services may be considered a qualified medical expense. Many Sound Beginnings clients pay for consultations with an HSA/FSA debit card; we recommend checking with your plan administrator prior to using an HSA/FSA debit card to pay for a consultation to avoid any penalties.
All non-Aetna clients will be provided a “superbill” or detailed receipt within one week after their consultation. This may be submitted to your insurance for reimbursement. Sound Beginnings does not file any paperwork with insurers for non-Aetna clients.
Travel fees and phone consultations are not typically covered by insurance.
Sound Beginnings believes that every family should have access to lactation support regardless of their insurance coverage or financial situation. We are happy to provide information and a list of free and low-cost community resources upon request. Sound Beginnings also may offer alternative services, payment plans, or sliding scale payment options. If you need to discuss alternative payment arrangements, please contact firstname.lastname@example.org prior to booking.
Consultation Cancellation Policy
When you book a consultation, the lactation consultant blocks off time in her schedule in order to be available and travel to you during that window of time, which means she cannot book another client consultation at that time. Appointments are in high demand, and your early cancellation will give another person the possibility to have access to timely care. If you need to reschedule or cancel your appointment, you must give a minimum of 24 hours advance notice email email@example.com or call 206-973-0337, or the full cost of the consultation will be forfeited. If you cancel less than 24 hours before an appointment for reasons beyond your control (sudden illness, family emergencies, etc.), Sound Beginnings will determine on a case-by-case basis whether to reschedule at no cost or offer a full or partial refund, in Sound Beginnings’ sole discretion. Insurance billed appointments cancelled less than 24 hours before scheduled time will be subject to a $100 fee. This fee is not covered by insurance. If a cancellation is due to circumstances beyond anyone’s control, such as massive power outage or severe weather that requires you or us to have to cancel or be closed during regular business hours, Sound Beginnings will reschedule your existing appointment at no charge.