I am onboard with Aetna and filed my first claims at the end of last year. Reimbursement is dependent upon each persons insurance agreement. No two are the same. Getting prior authorization is the way to go, but I don't generally have the time for this. All of my clients who have insurance pay a $50 retainer fee. I charge the insurance for each visit at the optimal amount allowed. If the reimbursements add up to the private pay fee then the $50 is returned. If not then it is applied to the balance owed. Very rarely are my reimbursements >1/4 or >1/3 of the original charge. Many are not reimbursed beyond the first visit since the insurance sees no medical necessity... which always makes me laugh as they truly have no idea that a problem with multiple issues can not be solved in one visit...but such is life..  My status as a blue cross provider should be approved  by the end of April so when this is done I will know more on how they are reimbursing. 

I would not advised anyone to think of IBCLC world in a state like Nevada, that has an abysmal breastfeeding rate beyond the first few weeks of discharge, as a fulltime job. You will need to supplement your income with something else for the first few years as you build your practice. And we should all remember that I believe it is clearly stated in the IBCLC guidelines that you can not take from a free community group like LLL and create charged clients...but I may be wrong :) .

Best Wishes to all as we navigate this world of teaching the healthcare world how to treat us.  

Lisa Weinshenker, RN, IBCLC
Breastfeeding and Babies, Yeah!
www.breastfeedinglv.com
Las Vegas, NV

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