Hello - my name is Susan Splinter RN, IBCLC. I currently work fulltime in the hospital setting seeing both inpatients and outpatients for evaluation. I would like to know from those of you who are employed by a hospital, how you work with reimbursement. I do not do the coding, I do not do the billing, only entering "charges" associated with each pt. visit. I have been told that there is "no way" to bill for lactation services, it is coded in a way that reflects a "facility fee". Further - the only way to change the billing code, I would need to be a "health care provider" and the only way I would be considered a Health Care Provider would be if I was a "Nurse Practitioner", then the hospital could approach each insurance carrier and get a provider number for me (and my partners). I would like to know what others of you are doing. Some insurance carriers are reimbursing for what we do with the current coding system, others will not cover. Thank you in advance! You can respond to me privately.

Susan Splinter, RN, IBCLC
Lactation Services
Ext. 2967
Cell Phone 317-7933

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