Payment Options and Payment Policy
Batam Services offers different payment options.
- We are in network with most Aetna policies.
- We offer a service through The Lactation Network that will work with your insurance policy to try and secure coverage for those we are not in network with.
- We also offer self pay options and gift certificates in case you would like to put us on your registry.
- We are always happy to provide a superbill for you to send to your insurance.
Payment Policy all clients must sign to receive services.
BATAM SERVICES LLC PAYMENT POLICY
_____ I understand that payment is due at the time services are rendered. The credit card provided will be charged the same day as the appointment through Intake Q. I understand that I will receive paperwork (Superbill) to submit to my insurance for consideration of reimbursement, but that Batam Services does not guarantee reimbursement. The superbill (which will also serve as a payment receipt) will be coded appropriately to the level of service provided during the visit. If my location has a travel fee applied, I understand that this is not eligible for insurance reimbursement.
Payment Policy The Lactation Network
_____ I have been pre-approved via Lactation Network, and I understand that any portion of my bill that is not paid by The Lactation Network for any reason is then my responsibility (including but not limited to purchase of products, travel fees, etc.). I authorize a charge to my credit card on file for up to $75 for any outstanding balance. If this balance is greater than $75.00 Batam Services will contact me.
Payment Policy Aetna
_____ I am presenting an in-Network insurance card (Aetna) and I understand that any portion of my bill that is not paid by the insurance for any reason is then my responsibility. If my location has a travel fee applied, I understand that this is not eligible for insurance reimbursement. I authorize a charge to my credit care on file up to $75 for any outstanding balance after insurance has made their payment – this would be copay/co-insurance. If this balance is greater than $75.00 Batam Services will contact me. I understand that I will be given a grace period of 7 days to make the outstanding payment before a late fee of $25 will be assessed for every week (or 7 days) the invoice goes unpaid.
Cancellation policy: I understand that I am responsible for all charges associated with this visit. If I cancel with less than 24 hours notice, my credit card on file will be charged $100.
Rescheduling Policy: I understand that I am responsible for all charges associated with this visit. If I reschedule with less than 24 hours notice, my credit card on file will be charged $100.
My initial visit includes 1 week of follow up support by secure messaging, email, or text. Continued support is available for a weekly fee of $25. These fees are elective and not eligible for insurance reimbursement.
Batam Services LLC may communicate with my insurance company in reference to the services provided to me and my baby or babies. Batam Services LLC may communicate with my credit card company or bank for any payment related matters. It is my responsibility to provide accurate and current payment and insurance information. I will update my credit card information as needed and am responsible for any costs and fees associated with my failure to provide updated information.
If I would like to pay with another form of payment, I understand that my credit card must stay on file as a backup. Batam Services LLC also accepts cash or check payments as long as I let them know in advance of my payment being due that I would like to pay in an alternate form of payment (i.e., cash or check).
These policies apply to Batam Services LLC and its representatives.
If you disagree with or have a question about your invoice, please do not hesitate to call us at (832) 441-0111 or email us at email@example.com.