We're in the unfortunate process of a crack down on health care costs. While we look to hiring a F/T IBCLC again, I have been asked to see what money we can charge for lactation services. I surveyed all the hospitals in our area regarding what charges they charge for outpatient lactation consults. From what I have gathered, none of them bill insurance companies directly. The charge the mother when she comes to her appointment. The burden of insurance reimbursement is then placed on the mother. For mothers that are on Medicaid, I am told, that other hospitals refer them to their WIC peer counselor if they cannot afford to pay the outpatient consult fee. Here's the fee schedule for the hospitals in the Greater New Orleans area:
1/2 hour = $30.00
1 hour = $50.00
1 1/2 hours = $75.00
Is this similar to what your hospitals charge? Have any of you had experience with billing insurance companies directly & what response do you usually have? Are you aware with any inpatient charges that can be billed that cannot be lumped into the standard per diem room rate for insurance companies? Do you charge your inpatients for items like lanolin, gel pads, nipple shells/shields, etc? Who pays this? Do you collect payment directly from the patient? What about when an inpatient needs a pump kit? What if she needs bigger flanges than are included with the kit? Do you bill her separately for the larger flanges?
Do you have a charge master or super bill that you use for your lactation consults? Do outpatient consults sign a consent? Do you require a MD order to see an outpatient consult or are patient requested consults accepted alone?
I know I have a lot of questions but the future success of our lactation program depends greatly on the additional funding sources I can hunt down. Any advice will greatly be appreciated!
Sincerely,
Mindy Glenn, RN, CLC, CPST
NICU Discharge Planner/Educator
Child Passenger Safety Technician
West Jefferson Medical Center
Office: (504) 349-2173
Pager: (504) 668-0362
Fax: (504) 349-6122
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of LACTNET automatic digest system
Sent: Monday, October 11, 2010 11:00 PM
To: [log in to unmask]
Subject: LACTNET Digest - 11 Oct 2010 (#2010-818)
There are 5 messages totaling 198 lines in this issue.
Topics of the day:
1. LACTNET Digest - 11 Oct 2010 - Special issue (#2010-816)
2. Can I please rant?
3. AAP statement
4. SGA premie
5. Traveling to and from England back to USA
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Date: Mon, 11 Oct 2010 18:56:02 -0700
From: Kathleen boggs <[log in to unmask]>
Subject: Re: LACTNET Digest - 11 Oct 2010 - Special issue (#2010-816)
Is it linked to the dx of jaundice or perhaps could it be linked to the treatment, I.e. phototherapy?
Kathy Boggs,RN,IBCLC
Sent from my iPad
On Oct 11, 2010, at 3:09 PM, LACTNET automatic digest system <[log in to unmask]> wrote:
>
>> My last of three posts for the day.
>>
>> Autism linked to jaundice in newborns, study finds
>> Researchers who studied all babies born in Denmark between 1994 and 2004
>> found that full-term newborns diagnosed with jaundice were 67 percent more
>> likely to develop autism than those without jaundice.
>>
>>
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Date: Mon, 11 Oct 2010 22:19:05 -0400
From: [log in to unmask]
Subject: Can I please rant?
My daughter Stacy is pregnant again with her 3rd child. She lives on a barrier island off the coast of NC and the nearest OB and hospital is 65 miles north, She doesn't have many options for health care and childbirth with only 3 doctors to choose from, and one being the one that was horrible to her during the first one (he threatened to kick her out of the hospital and to the parking lot during that childbirth). She is having to endure a glucose test tomorrow because the MD said she "has to", and "it is required". The nurse said if she doesn't have it "the baby may die", "it is required by law" and "if you don't have it, you will be classified high risk". If she doesn't, she can be dismissed from his practice. How do nurses and doctors get away with this type of scare tactics? She has no symptoms to indicate a need for this test, as well as no risk factors. Why is it that mothers who want to have normal, healthy pregnancies, labors and deliveries, and breastfeeding experiences have to fight, argue and submit to this type of tyranny and threats? Her friends who deliver here where I live, undergo the same type of threats and scare tactics, even though the hospital here is almost finished with being designated BabyFriendly.
Anyone know a midwife who would like to spend the holidays on an island and do a delivery at home??
Barbara Whitehead
eastern NC
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Date: Mon, 11 Oct 2010 22:07:39 -0500
From: Nancy Mohrbacher <[log in to unmask]>
Subject: AAP statement
Hi Amy,
In answer to your question about early vitamin supplementation and
allergy, the following is an excerpt from my 2010 tome, Breastfeeding
Answers Made Simple (p. 244):
One preliminary Swedish study of 206 babies found an association with
vitamin D intake during the first year of life and increased risk of
allergy independent of family history (Back, Blomquist, Hernell, &
Stenberg, 2009). A U.S. study found that early vitamin use was
associated with a higher risk of allergy among exclusively formula-fed
African-American babies (Milner, Stein, McCarter, & Moon, 2004)
Back, O., Blomquist, H. K., Hernell, O., & Stenberg, B. (2009). Does
vitamin D intake during infancy promote the
development of atopic allergy? /Acta Dermato-Venereologica, 89/(1), 28-32.
Milner, J. D., Stein, D. M., McCarter, R., & Moon, R. Y. (2004). Early
infant multivitamin supplementation is associated with increased risk
for food allergy and asthma. /Pediatrics, 114/(1), 27-32.
Warm regards,
Nancy Mohrbacher, IBCLC, FILCA, LLL
Lactation Consultant, Ameda Breastfeeding Products
Chicago suburbs
www.NancyMohrbacher.com <http://www.nancymohrbacher.com/>
> This part really struck me: "vitamins under the age of 6 months can increase
> the risk of food allergies, asthma and eczema." Does anyone have sources on
> this? I'm really interested! =)
>
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Date: Tue, 12 Oct 2010 14:38:25 +1100
From: Nina Berry <[log in to unmask]>
Subject: Re: SGA premie
Nancy,
I am wondering if it is possible to give these infants the extra nurients they need (calcium, phosphorus, amino acids) without exposing them to cow's milk?
Nina Berry
Australia
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Date: Tue, 12 Oct 2010 14:44:30 +1100
From: Nina Berry <[log in to unmask]>
Subject: Re: Traveling to and from England back to USA
I recently travelled to the US and the UK (from Australia through Frankfurt, Munich, Heathrow, LAX, SAT and FWT) with close to 2kg of supplements and medications. I had a letter from my prescribing doctor outlining what I had with me. The only time I was asked for it was in Hong Kong on the way home.
Nina Berry
Australia
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End of LACTNET Digest - 11 Oct 2010 (#2010-818)
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