Arly, you asked about informing patients of the charge for service in a hospital
setting....I assume that you are referring to inpatients.   Do you see patients
by physician referral?  A specialist fee would be expected, it seems to me.  The
physician would be the one to mention this to the patient at the time of
discussing the need for such service.    Or do you see them by nursing staff
referral?  If a staff nurse is the one referring, she/he could ask the patient
is she wanted an IBCLC to help her with breastfeeding and explain that there
would be a fee for such specialized assistance.  In either case the patient is
aware of the fee for service.

I agree that it would be uncomfortable to see a patient as if on regular rounds,
see that help is needed, and then say I can help you and $### per #minutes will
be added to your hospital bill.  Sounds like door to door broom sales to me.

One of our local hospitals includes up to 15 mins. of IBCLC time in the
maternity charge.  Any increment of 15 mins. above that is a charge item.  How
many mothers have you helped in 15 mins.?!?!???  I think that is a good plan.
It lets mothers know of the service, see the face of the IBCLC, and
appropriately charges for specialized service.   Like a free taste of really
good fudge......after the taste, some of us have to purchase a box of it!!!  IF
a mother gets a bit of our help, she wants more....

Like Arly, I am interested in what others do for inpatient charging.

Pardee Hinson
Charlotte, NC
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