Lactora LLC Payment Policy

Effective May 16, 2026

Thank you for choosing LACTORA LLC for your lactation consultation needs. This policy explains our services, fees, insurance, cancellations, denied claims policy, and payment terms. By scheduling an appointment, you agree to these terms.

Services & Fees

  • Prenatal Consultation (60 min): $225 – Includes preparation and individualized care plan

  • Initial Lactation Consultation (60 min): $225 – First postnatal visit; includes assessment, latch, pumping plan if needed

  • Follow-Up Consultation (45 min): $190 – Ongoing support and troubleshooting

  • Additional Time: $30 per 15 min – For extended visits or complex needs

  • Multiples (Per Additional Infant): $100 – Covers additional time, individualized assessment, and guidance

  • Travel Fee (In-Person Visits): $125 – Required for all home visits; not reimbursable by insurance

  • Non-Medical Classes: $75–$175 – Per LCA/TLN guidelines; not reimbursable by insurance

  • Late Cancellation Fee (<48 hrs): $100 – COVID-19/contagious illness exceptions apply

  • No-Show Fee: $175–$225+ – Charged for missed appointments without notice; fee amount is based on the scheduled service

Note: Virtual visits do not incur a travel fee. Clients may choose telehealth as an alternative to in-person visits.

Insurance Coverage

Lactora LLC Direct Services:

  • Clients are responsible for verifying coverage and submitting claims.

  • Lactora LLC cannot guarantee insurance reimbursement.

  • Claims for both parent and baby may be submitted if in-network.

  • Most lactation claims involve cost-sharing (deductible, copay, or coinsurance).

  • Travel fees and non-medical classes are not reimbursable.

LCA Clients:

  • Claims may be submitted for both parent and baby if in-network.

  • Clients are responsible for cost-sharing.

  • Travel fees and non-medical classes are not reimbursable.

TLN Clients:

  • TLN-approved visits may be fully covered with no out-of-pocket cost.

  • Once TLN-approved visits are exhausted, standard Lactora LLC rates, including travel fees, apply.

  • Coverage determinations are made by TLN and insurance, not LACTORA LLC.

Superbills for Insurance Reimbursement

Upon request, LACTORA LLC may provide a superbill for self-pay clients to submit to insurance for possible reimbursement.

Please note:

  • Reimbursement is not guaranteed.

  • Clients are responsible for communicating with their insurance company.

  • LACTORA LLC is not responsible for denied or partial reimbursement.

Denied Claims

Clients are financially responsible for all charges incurred under their care, including services that are denied, reduced, or applied to deductible by insurance.

This includes:

  • All lactation consultation services.

  • Copayments, deductibles, coinsurance.

  • Denied or non-covered services.

  • Travel fees and other non-reimbursable charges.

If a claim is denied, reduced, or not paid in full:

  • The client is responsible for the remaining balance.

  • Charges are based on the scheduled service rate at the time services were rendered.

LACTORA LLC may assist with documentation or appeals when appropriate; however, financial responsibility remains with the client during the appeal process.

Claims denied solely due to a LACTORA LLC billing or coding error will not be charged to the client.

Payment & Credit Card Authorization

A valid credit card is required to remain on file for all clients.

By scheduling or receiving services, you authorize LACTORA LLC to securely store and charge your card on file through PracticeQ (or Stripe for LCA clients) for all services and fees incurred, including:

  • Scheduled services

  • Travel fees

  • Additional time or services rendered

  • Late cancellation and no-show fees

  • Insurance patient responsibility amounts (copays, deductibles, coinsurance, denied claims, or non-covered services)

You understand and agree that:

  • Charges may be processed without additional authorization once services are rendered or fees are incurred

  • Invoices or insurance statements (EOBs) may be provided for informational purposes but are not required prior to processing payment

  • Payment information is securely stored through HIPAA-compliant processors

  • You are responsible for keeping an active payment method on file

  • If no card is on file, payment is due within 30 days of invoice

  • Alternative payment methods may be accepted at LACTORA LLC’s discretion

  • Failure to maintain a valid payment method may result in delayed scheduling or suspension of services

Client Responsibility

Clients agree to:

  • Verify insurance coverage and benefits in advance

  • Understand and accept responsibility for all non-covered services

  • Understand that travel fees, non-medical services, and denied claims are client responsibility

  • Provide accurate insurance and payment information

  • Use the following codes when verifying benefits:

    • S9443 – Lactation consultation

    • Z39.1 – Care of lactating parent

    • R63.3 – Feeding problem (infant)

Cancellations, Rescheduling & No-Shows

Rescheduling:

  • ≥48 hours in advance → no charge

  • <48 hours → $100 Late Change Fee (exceptions for emergencies)

Cancellations:

  • ≥48 hours → no fee

  • <48 hours → $100 Late Cancellation Fee + 25% of travel fee (if applicable)

  • COVID-19/contagious illness → can reschedule to virtual visit same date/time with no fee

No-Show:

Missing appointment or >15 minutes late without notice:

  • 100% of visit fee

  • 100% of travel fee (if applicable)

Client Consent & Acknowledgment

By scheduling or attending an appointment, you acknowledge and agree that:

  • You have read and understand this Payment Policy in full

  • You are financially responsible for all services, fees, and denied claims

  • LACTORA LLC does not guarantee insurance reimbursement

  • Travel fees apply to in-person visits; virtual visits do not include travel fees

  • You authorize insurance claim submission on your behalf when applicable

  • You are responsible for all cancellation, rescheduling, and no-show fees as outlined above

  • You authorize LACTORA LLC to charge your card on file for all services and fees incurred in accordance with this policy