Cathy, I suggest you download and read this fabulous resource from USLCA:
http://www.ilca.org/files/USLCA/Resources/Publications/Containing_Health_Care_Costs_Help_In_Plain_Sight_2ndEdition.pdf


In a nutshell, the fact that you already work in a pediatric office gives
you (and them) a "leg up" on getting IBCLC services reimbursed by private
insurers, because the doctor or NNP who is part of the office visit can be
the "hook" to validate a diagnosis code for lactation-related issues in the
baby.  Doctors can diagnose; IBCLCs [with no other certification or license
offering diagnosis powers] cannot.

For your private practice, you will have to become familiar with the
various private insurance programs in your area, and make a business
decision of your own as to whether you want to  sign up to be on their list
of recognized providers.  Starting Aug 1 2012, mothers began (dep. on the
timing for their plan renewals)  to become eligible for no-out-of-pocket
healthcare services (like those you keep getting sent to read about on the
federal healthcare.gov site).  If you do sign up with an insurance company,
you will have to agree to be paid what they offer for each consult.  If you
do not sign up with the insurance company, you will have to rely on a
clientele that is willing to pay you out-of-pocket for your services.  That
really is not too different from what private practitioners face now in the
USA ... but as more mothers become aware of their preventive healthcare
privileges, more may say "Well, heck. I'm gonna find an IBCLC who is
covered by my insurance!  That's what I got it for!"  You know what your
market will bear ... I do not.

You will also want to think about purchasing the DVDs of two recent
ecellent USLCA webinars that discussed coding issues, and aligning with one
large insurance company; scroll all the way to the bottom of the page at:
http://www.ilca.org/i4a/pages/index.cfm?pageid=3892

-- 
Liz Brooks JD IBCLC FILCA (ILCA Pres 2012-14)(who spotted three gorgeous
benefits of USLCA/ILCA membership in this post alone)
Wyndmoor, PA, USA

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