Please direct any questions and concerns regarding insurance to our billing department at 301-801-9070 or firstname.lastname@example.org Thank you.
To our valued clients:
At this time, we are in-network with Blue Cross/Carefirst and Cigna and out-of-network with other providers. Whether or not you have out-of-network benefits, we require that you provide a valid credit card for services we provide to you. Although many insurance plans offer out-of-network benefits, we generally do not obtain payment directly from the insurance company and must ask that you, the patient, be responsible for any charges to your account with Metropolitan Breastfeeding.
A service charge of $15 will apply if your insurance company requires Metropolitan Breastfeeding to submit the claim form(s) on your behalf.
As a courtesy, due to lengthy processing times associated with insurance submissions, we are offering to assist you by postponing any charges to your credit card account for 30 days. Delinquent accounts after the 30-day grace period will be sent directly to collections.
It is the patient’s responsibility to verify eligibility for insurance reimbursement PRIOR to obtaining services from Metropolitan Breastfeeding.
Payment plans and other payment arrangements are also available. Please inquire for more details.
A: If you seeing us without using insurance benefits, we will provide you with a universally-recognized medical form that you can submit to your insurance company for reimbursement depending on your plan benefits. If you have questions about this process, please click here. We will happily make special accommodations depending on your situation.
A: Yes, we do accept any HSA/FSA account with a valid Visa or MasterCard logo.
A: Many times, insurance companies will reject a claim if certain unique criteria are not met. These issues are often simple to resolve, and we would be happy to assist you in obtaining a resolution. Additionally, please be advised that it is very important to check with your insurance company prior to receiving our services if you are unsure that your insurance company will reimburse you. We do offer other options if your insurance company will not cover a visit with us, or if they will only cover a visit under certain circumstances. Please send any communications regarding insurance claims to:
4927 Auburn Avenue, Suite 100
Bethesda, MD 20814
A: We would be happy to submit your medical forms to your insurance company on your behalf. For a $15 fee*, we will obtain your insurance information, properly complete your medical form, submit the form to your insurance company, send you copies of all documents which have been submitted, and provide limited follow-up with your insurance company.
*We will charge your credit card on file $15 for each medical form we submit to your insurance company.
A: Insurance companies are now offering their members free breastpumps available through DME (durable medical equipment) suppliers who are set up to bill insurance companies directly. The breastpumps offered by these suppliers are generally not sufficient for the duration many mothers intend to breastfeed. For this reason, we discourage mothers from using these “personal-use pumps,” and instead consider renting a hospital-grade pump. However, if you would still like to purchase your breastpump from Metropolitan Breastfeeding and attempt reimbursement from your insurance company, please consider that once a personal-use pump has been opened, it cannot be returned if your insurance company has failed to reimburse you for it.
The models available for purchase are the Medela Freestyle and the Medela Pump in Style. The pricing for these breastpumps is available upon request. We can also order (for purchase) the Medela Symphony, which is a hospital-grade breastpump and is significantly more expensive than either the Freestyle or the Pump in Style.
Please click here for a complete listing of our breastpump purchase return policies.
Q: What information do I need to have before I place a call to my insurance company to verify possible benefits for your services at Metropolitan Breastfeeding?
A:Depending on what services you are interested in from Metropolitan Breastfeeding, it may be helpful to have the following information handy before placing your call:
- The name of the patient(s). During a lactation visit, some insurance companies may consider the mother the patient, while others may consider the baby the patient. Please be sure to ask this question, as it is helpful to know when completing your reimbursement form after you’ve received our services.
- The patient(s) date of birth. If your baby is unborn, state whether you intend to have our services before or after delivery. For your convenience, if you are picking up your breastpump prior to your baby’s birth, we would not start the billing cycle until the day your baby is born.
- The name of the insured. This is the name that appears on the card for the plan you intend to use.
- The insured’s date of birth.
- Your Member ID Number. This number will generally be assigned by your plan; however, there are insurance companies that use the member’s social security number for this purpose. It is located on your insurance card.
- Your Group Number. A vast majority of insurance companies utilize a group number. It is located on your insurance card.
- Provider information. Your insurance representative will ask if you have any information about the provider you wish to visit. Please call 301-801-9070 or e-mail us at email@example.com to request this information.
- Services requested. All healthcare procedures have codes assigned to them so insurance companies can quickly process claims without the need to decipher the exact service performed. The following codes are for our primary services:
HCPCS Code & Modifier
|Hospital-grade breastpump rental||
|Breastpump purchase (personal-use pump)||
9. After providing your basic information, you may want to consider asking these questions to be as knowledgeable about your benefits as possible:
- Do I have out-of-network benefits?
- Do I have an out-of-network deductible that needs to be satisfied before I will receive benefits? If so, how much of my out-of-network deductible has already been satisfied for this year?
- If I have out-of-network benefits, what is the rate at which I will be reimbursed based on the procedure codes I have provided to you?
- Do I need to obtain prior authorization for these services?
- Do I need to obtain a prescription from my doctor if I do not receive a consultation from Metropolitan Breastfeeding but I do intend to rent a hospital-grade breastpump? (For a downloadable prescription you can take to your doctor, please click here.)
- Do I need to obtain a referral from my doctor if I intend to receive a consultation from Bethesda Breastfeeding?
- Is it permissible to have these services performed prior to the birth of my child?
- Are there any special requirements I need to keep in mind when I am ready to have these services performed? (Insurance companies sometimes have requirements about where visits can take place and what type of provider can perform the services.)
I'm having issues with my insurance company providing the coverage I expected. Do you have any tools for this?
A:Yes! The National Women’s Law Center has put together some very helpful forms for you to use.
For an excellent resource in understanding your coverage under the new Health Care Law, click here. (Provided by the National Women’s Law Center).