Our Commitment to Ethical & Compliant Operations
We support IBCLCs by offering credentialing support and billing services that align with federal and state requirements. Our business practices are structured to ensure accuracy, integrity, and compliance across all administrative processes. We maintain ongoing consultation with qualified healthcare legal counsel to ensure our policies, procedures, and agreements remain aligned with applicable regulations.
Protecting patient information is central to our operations. Our compliance approach includes:
We use updated malware protection and dedicated HIPAA-compliant systems to safeguard electronic information.
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.
We maintain BAAs with all applicable partners and vendors who may interact with protected health information (PHI).
Our policies and procedures are reviewed regularly with legal guidance to ensure continued compliance with federal and state privacy standards.
We follow strict administrative, technical, and physical safeguards to ensure PHI is used and disclosed only as permitted for billing, credentialing, and healthcare operations.
We access and use only the information required to perform billing and credentialing functions.
PHI is stored on encrypted systems and transmitted only through approved HIPAA-compliant channels.
Access to PHI is limited to authorized personnel involved in billing and administrative processes.
We retain billing records for six years, consistent with federal requirements for HIPAA-related documentation and healthcare financial records. Providers are expected to retain charting.
Our billing services reflect the documentation and scope of practice of the IBCLC providing care. Insurance coverage varies by plan and payer.
Submission of a claim does not guarantee payment. Patients may be responsible for deductibles, copays, coinsurance, or services not covered by their plan.
If a service is not covered by a patient's insurance, the patient may be billed directly according to the provider's fee schedule.
Patients are encouraged to verify their lactation benefits with their insurance plan prior to receiving services.
We support IBCLCs by managing credentialing processes with commercial payors in Idaho. Our credentialing practices include:
We follow payor-specific guidelines for preventive services and billing requirements.
We review payor contracts and renewal requirements to ensure providers remain active and compliant.