Billing Policy & Self-Pay Responsibility

JDNA may help clients check possible insurance, Medicaid, NJ FamilyCare, or private plan coverage options for doula care, lactation support, childbirth education, postpartum care, and related maternity support services.

Insurance coverage depends on your specific plan, eligibility status, provider network status, covered benefits, medical necessity rules, authorization requirements, coding rules, claim submission rules, documentation requirements, and final payer decision.

Clients are responsible for confirming their own benefits directly with their insurance plan, Medicaid/NJ FamilyCare managed care organization, employer benefits program, or third-party payer.

Before receiving services, clients should confirm:

• Whether doula, lactation, postpartum, childbirth education, or maternity support services are covered
• Whether prior authorization is required
• Whether the provider is in-network or out-of-network
• Whether there are visit limits or timing restrictions
• Whether the service requires a referral, prescription, diagnosis code, or documentation
• Whether the client has a deductible, copay, coinsurance, or other cost-sharing responsibility
• Whether the service is excluded or considered non-covered

JDNA may assist with this process as a courtesy, but the final responsibility for understanding benefits and financial responsibility remains with the client.

You may be financially responsible for services if:

• You do not have active insurance coverage on the date of service
• You choose not to use insurance or choose a self-pay service
• The service is not covered or is denied by your insurance plan
• Your plan determines the service is not medically necessary
• Your plan requires prior authorization and authorization is not approved
• Your insurance information is inaccurate, inactive, incomplete, or not provided in time
• You receive services before coverage, authorization, or network participation is confirmed
• You choose to work with a provider who is out-of-network or not participating with your plan
• You request services beyond what your insurance authorizes
• You miss an appointment, cancel late, or do not follow the cancellation policy
• You request urgent support, private-pay support, or add-on services that are not billed to insurance

Self-pay responsibility only applies where permitted by applicable law and payer rules.

If you are enrolled in Medicaid or NJ FamilyCare, special billing rules may apply. JDNA and participating providers will follow applicable Medicaid, NJ FamilyCare, managed care, and legal requirements.

Emergency services are not covered by this self-pay policy and should be handled through emergency medical services, 911, your hospital, or your licensed medical provider.

Some insurance plans require prior authorization before services are provided. If authorization is required, services should not be considered approved until written or electronic approval is received from the payer.

Submitting an authorization request does not guarantee approval. If you choose to receive services before authorization is approved and the payer later denies payment, you may be responsible for payment if permitted by law and if you agreed in writing before receiving the service.

JDNA or a participating provider may submit claims, documentation, invoices, superbills, or reimbursement forms as a courtesy. Courtesy billing does not guarantee that the claim will be paid.

If a payer denies, delays, underpays, recoups, or refuses payment, the client may be responsible for any balance that is legally billable under this policy and applicable law.

For self-pay services, payment is due at the time of booking, before the appointment, or according to the payment terms listed at checkout, on the invoice, or in the service agreement.

Self-pay services may include, but are not limited to:

• Urgent doula chat or phone support
• Urgent lactation support
• Prenatal consultations and birth planning sessions
• Childbirth education and postpartum planning
• Lactation visits and postpartum doula support
• Private doula services
• Provider matching or concierge support
• Provider directory or lead-generation services
• Mentorship, training, or business support services

Some services may require a deposit, retainer, or full payment before services begin. Payment plans may be offered at JDNA's discretion. If a payment plan is approved, the client remains responsible for all scheduled payments unless a written refund, cancellation, or modification agreement is approved by JDNA.

Failure to complete payments may result in suspension of services, cancellation of appointments, removal from a provider's schedule, or collection activity where permitted by law.

Cancellation and no-show rules may vary by service or provider. Unless a different written policy applies:

• Appointments canceled with less than 24 hours' notice may be subject to a cancellation fee
• Missed appointments may be non-refundable
• Late arrivals may shorten the appointment time
• Urgent support purchases may be non-refundable once support has begun
• Birth doula retainers may be non-refundable once the on-call period begins or according to the signed service agreement

Refunds are not guaranteed and depend on the service purchased, timing of cancellation, provider availability, work already performed, administrative costs, and any written service-specific policy.

Refunds may not be available for:

• Completed services or missed appointments
• Late cancellations
• Urgent support already started
• Administrative or intake work already completed
• Provider matching or referral work already performed
• Birth support retainers once the provider is on call
• Digital products, downloadable materials, or completed consultations

If JDNA or a provider is unable to provide a paid service, we may offer a refund, credit, rescheduling option, or replacement provider depending on the situation.

Some providers may be out-of-network with your insurance plan. Out-of-network services may result in higher out-of-pocket costs, denied claims, partial reimbursement, or no reimbursement.

Clients are responsible for understanding their plan's out-of-network benefits before receiving services. JDNA does not guarantee reimbursement for out-of-network services.

For some self-pay services, JDNA or a provider may provide a superbill or receipt that you can submit to your insurance plan for possible reimbursement. A superbill is not a guarantee of reimbursement — your insurance plan may deny the claim or reimburse only part of the cost.

You are responsible for submitting the superbill unless JDNA or the provider separately agrees to assist.

If a payment fails, is reversed, disputed, charged back, or not completed, JDNA may contact you to update your payment method. Outstanding balances may result in:

• Paused services or canceled appointments
• Loss of access to paid features
• Removal from provider matching or directory services
• Late fees where permitted
• Referral to collections where permitted by law

If you believe there is a billing error, please contact JDNA first so we can review and attempt to resolve the issue.

Filing a chargeback after receiving services does not automatically remove your responsibility for payment. JDNA reserves the right to dispute chargebacks and provide documentation of services, consent, appointment history, payment authorization, and communications.

JDNA may list or refer clients to independent providers. Provider fees, billing practices, accepted insurance plans, cancellation policies, and payment requirements may vary.

Unless otherwise stated in writing, independent providers are responsible for their own billing, fees, contracts, refund policies, and insurance participation. Clients should confirm pricing and payment terms directly with the provider before receiving services.

By submitting an intake form, booking a service, requesting support, using JDNA's platform, signing a service agreement, or submitting payment, you acknowledge and agree that:

• Insurance coverage is not guaranteed; a coverage check is only an estimate or screening
• You are responsible for confirming your own benefits
• You may be responsible for payment if insurance denies or does not cover the service, where permitted by law
• You agree to pay self-pay fees for services you knowingly purchase as private-pay services
• You understand that Medicaid/NJ FamilyCare billing rules may limit when you can be billed
• You agree to provide accurate insurance and contact information
• You agree to notify JDNA of any insurance changes before services are provided

For billing questions, coverage check questions, payment issues, or refund requests, please contact: