In a message dated 10/16/99 11:22:01 PM Eastern Daylight Time,
[log in to unmask] writes:
Dear Susan, Chris, and fellow lactnetters,
    Congratulations, Chris, on being IBCLC!!!  Susan makes excellent
suggestions to Chris about getting paid for home visits.  As an LC who has
been in private practice for a decade, I am concerned with the following:
<< Perhaps you can get information, facts, statistics, etc. from established
home care
 agencies that offer lactation services. >>
    I have found that at least in my area, the amount that the home health
agencies pay is driven by  the insurance companies and is ridiculously
inadequate.  When faced with a drive to a client's home, a 90 minute
consultation, the drive back to my office, the letter to the physician and
phone follow-up, the amount that is paid is too small to support a practice.
One home health agency director suggested that I not do the consultation
report or phone follow-up to save time.
    I will not let insurance companies change the way I practice, so I no
longer do home visits for home health agencies, and encourage others in the
area not to as well.  I feel that to do so *enables* a system of
reimbursement that does not value our services.  For a short time, the
mothers and babies suffer as they receive sub-standard care provided by their
insurance companies.  Ultimately, it is my hope that many more mothers and
babies will benefit as their insurance companies begin to pay appropriately
for excellent care.  Excellent lactation management, in the long run, saves
them money!
        Oh!  Is this a soap box?  Sorry!  I understand that lacntet is not
the venue to discuss compensation, but I will be happy to e-mail anyone
interested an article I did on setting fees.  It does not include specific
numbers and in no way should be construed as price fixing.

Debi Page Ferrarello, RN, IBCLC
Breastfeeding Resources, Inc.
Abington, PA

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