I'd like some advise from all you lactnetters.  I have been practicing as a
LC and home follow up nurse (telephone follow up assessment for all new
mothers) for the last two years.  I have been hounding my supervisor to come
up with some way to charge for services as a LC.  She has pursued this
through the usual chain of commands and to no avail, she has bugged the
accounting dept. for months.  They have said that because reimbursement is so
iffy for lactation and the paper work is so huge that its not worth the
trouble for the few clients I see.  You would think that the hospital would
jump at a chance to get funds.  My salary comes from education ie. prenatal
ed. funds.  I work as many hours as I need and I have not been hastled about
the time I spend with clients. (I average 30 hours a week).  I have expressed
my concern that this service does need to be reimbursed some way or it will
go by the wayside and the budget ax.
My question is this....Should I start raising some hell with the director of
nursing, budget dept. insurance co. or what.  The whole OB dept. values the
service I offer.  I know this position would be greatly missed if it was
eliminated. (no plans for this at all) The nurse who does diebetic education
to outpatients charges for services as well as dieticians.
My other concern is...If we do charge for services, and the Ins. co or
Medicaid (the vast majority of our cliets are medicaid) refuse to pay for the
service, what happens then?  I know most of these folks will be unable to pay
out of pocket.  So, those of you who charge for services what happens, should
I leave well enough alone or is it worth the trouble to get fees?

Linda Rosetti RN, IBCLC
Clarkston, Wa.
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