Ethical, compliant operations — documented and reviewed.
We support IBCLCs with credentialing and billing services that align with federal and state requirements — structured for accuracy, integrity, and compliance across every administrative process, with ongoing consultation from qualified healthcare legal counsel.
Our Approach to HIPAA Compliance
Protecting patient information is central to our operations.
Secure Technology Infrastructure
We use updated malware protection and dedicated HIPAA-compliant systems to safeguard electronic information.
HIPAA-Compliant Communication
Charting is received through HIPAA-compliant email, claims are submitted through a HIPAA-compliant clearinghouse, and all faxed documents are transmitted through HIPAA-compliant faxing solutions.
Business Associate Agreements (BAAs)
We maintain BAAs with all applicable partners and vendors who may interact with protected health information (PHI).
Ongoing Policy Review
Our policies and procedures are reviewed regularly with legal guidance to ensure continued compliance with federal and state privacy standards.
How We Handle PHI
Strict administrative, technical, and physical safeguards ensure protected health information is used and disclosed only as permitted for billing, credentialing, and healthcare operations.
Only What's Required
We access and use only the information required to perform billing and credentialing functions — the minimum necessary standard, applied every time.
Encrypted End to End
PHI is stored on encrypted systems and transmitted only through approved HIPAA-compliant channels.
Authorized Personnel Only
Access to PHI is limited to authorized personnel involved in billing and administrative processes.
Billing records retained for six years.
Consistent with federal requirements for HIPAA-related documentation and healthcare financial records. Providers are expected to retain their own charting.
Patient Responsibility & Non-Covered Services
Our billing services reflect the documentation and scope of practice of the IBCLC providing care. Insurance coverage varies by plan and payer.
Insurance Coverage
Submission of a claim does not guarantee payment. Patients may be responsible for deductibles, copays, coinsurance, or services not covered by their plan.
Non-Covered Services
If a service is not covered by a patient's insurance, the patient may be billed directly according to the provider's fee schedule.
Verification of Benefits
Patients are encouraged to verify their lactation benefits with their insurance plan prior to receiving services.
Credentialing & Payor Compliance
We support IBCLCs by managing credentialing processes with commercial payors.
Adherence to Payor Policies
We follow payor-specific guidelines for preventive services and billing requirements.
Ongoing Contract Review
We review payor contracts and renewal requirements to ensure providers remain active and compliant.