I am hospital based.  When we first started our outpatient - storefront
center we did not charge for visits.  But that changed with budget adjustments.  I
am just happy we still have Lactation Services, even though we have had our
hours cut.  Since the charging started we see far less patients.  We did over
430 deliveries last month but I only saw 4 outpatients.  I try really hard to
help over the phone.  If I am working alone I may not even have time to do a
good job with that.  So I am referring to LLLL and community based LCs as needed.
 We do have moms who would prefer home visits so I do refer out.  And to be
honest if I am alone working with 43 Post Partum moms and our Level II NICU is
overflowing, right now, with twins and triplets, I just can't be a proper LC
all on my own.  If I am drowning at work, alone, I need outside help.  We have
a sister hospital across town that I, of course, will refer to but our moms
rarely want to travel across town.  We allow 3 visits for 100.00, which is a
good deal.  We do not bill.  I have tried and tried to get the hospital to listen
to me about this but if falls on deaf ears.  So the moms pay up front and
then she tries to file with her insurance.  We give her the billing code form.

Pam Hendrix, BA, RN, IBCLC
Hospital Based in S. Florida

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