click on links below to learn about each topic
Required Fees
| Start Up |
$100.00 |
one time charge to set up provider information, facilities, and remittance offices in our clearing house software (required to submit claims); train provider over the phone on our e-superbills and insurance EOBs, and explain how we can help handle verifications, exceptions, appeals and accounts receivable |
| Claims |
12% |
on collected amounts for claims submission, includes correction if biller error and the posting of payment information |
| Out of Network Submission Fee |
$15.00 |
per claim at time of submission, plus 12% on collected amounts |
| Denied Claims (In Network) |
$15.00 |
per denied in network claim when the whole date of service does not pay; then to be refunded only if the amount due from a reworked paid claim is more than $15; if amount paid is less, then $15 is all that is owed |
Optional Credentialing Tasks
| In Network Contract or Modification to Existing Contract |
$150.00 |
$75 to start the process with each insurance company in each state, and $75 when the contract is received for each state |
| Demographics (address, name, EIN) Change |
$50.00 |
per incident charge, per insurance company |
| NPI Set Up |
$35.00 |
one time charge |
| CAQH Set Up |
$100.00 |
one time charge |
| CAQH Annual Maintenance and Quarterly Reattestations |
$75.00 |
annually |
| Healthcare Network Set Up (such as Navinet and Optum) |
$50.00 |
per incident charge, per network |
| Electronic Funds Transfer (EFT) Set Up |
$50.00 |
per incident charge, per insurance company |
Optional Practice Assistance
| Verification of Benefits |
$30.00 |
per incident charge |
| In-Network Gap Exception or Pre-Authorization |
$50.00 |
per incident charge, includes verification of benefits and gap or pre-auth application |
| Fillable Personalized Provider Paper Superbill |
$75.00 |
per provider to give to patients who are out of network, (includes training on how to properly fill them out) |
| Updated Fillable Personalized Provider Paper Superbill |
$35.00 |
per provider to give to patients who are out of network, for LCB clients who already have a superbill from LCB and want the latest updates |
| Practice Management |
$120.00 |
per month, (up to 25 visits per month), includes reading through chart notes to determine diagnosis codes and other claim information, and sending information to LCB billers for processing through online superbill |
| Explanation of Benefits (EOB) Dropbox Maintenance |
$25.00 |
per month, per provider to store all your EOBs in one place, properly labeled |
| Accounts Receivable Management |
$45.00 |
per month, plus 12% on collected amounts, up to 20 families per month, up to three monthly invoices per patient per date of service |
Optional Claims Assistance
| Basic Appeals |
$0 |
No Charge |
| Second Level Appeals |
$50.00 |
per hour, which can include filling out appeal forms and/or writing letters for an appeal or to explain medical necessity to insurance companies; second level appeals will be approved by client prior to LCB working on them |
| Sending Chart Notes |
$20.00 |
per patient, separate notes are prepared and sent for mother’s and baby’s charts; includes calling insurance company to confirm receipt |
Legal and Late Payments
| Legal Issues |
$200.00 |
per hour, can include writing letters, declarations, or anything to do with court activity requested by the lactation consultant |
| Late Fee on Payment to LCB and/or Credit Card Denied Fee |
$25.00 |
per billing cycle if bill is unpaid |
