Many insurance providers, by law, do cover outpatient lactation services. It is best to check first for “In Network” IBCLCs. If no “In Network” IBCLCs are available the insurance provider is supposed to provide reimbursement to the Family of the standard fee the Family pays directly to the Lactation Consultant. Some require their own designated forms to be completed for this process. It is best to call ASAP to find out what benefits you have and what documentation/ referrals your insurance carrier requires.
I am currently “In Network” with AmeriHealth and Independence Blue Cross if your plan offers “Lactation Benefits”.
Referrals/ pre-approvals may be needed. A 50% deposit is requested ($85- home visit, $50-telehealth) for those whose insurance will be directly billed. For In Network Families a refund ( full/ partial) of the deposit would be planned pending claim outcomes, possible deductibles, copays or coinsurance.
For the first visit, I anticipate 1½ hours to learn a Mom/ Baby history, assess feeding and determine a plan of care addressing the concerns. Some nursing challenges may take a few visits to determine the need, appropriate plan for care and follow up. I will do my best to anticipate these and they would be at a reduced rate.
The initial home visit is $175.00 (determined by insurance codes). This includes follow up email, phone or text correspondence as desired and this (or the deposit) is paid at the first visit. Subsequent visits are $75.00. Basic insurance forms, including a receipt, are provided for submission for reimbursement for out-of- network Families.
HIPAA Compliant Video Conferencing (Telehealth) for urgent concerns is available until a home visit can be scheduled and is $100.00.
PLEASE, talk with me if special arrangements are needed. I believe a Family should have the breastfeeding/ feeding support they need and I will do my best to accommodate this.
Options: Checks, cash and credit/debit cards (FSA, HSA and medical expense) are accepted. Many Families have found the credit card option gives them more wiggle room in the budget, pending completion of insurance claims and reimbursements. I do have the very secure Square Card Reader and an option for an electronic invoice paid directly through your email which automatically generates a receipt for your records.
~Debbie Chalk RN, IBCLC, CPD