Thanks for sharing your experience Lisa.  It gives me hope that I can make it through this very long adn frustrating process.  I've had a number of appeals that I have had to submit recently for reimbursement and it does eat up time.  

"And we should all remember that I believe it is clearly stated in the IBCLC guidelines that you can not take from a free community group like LLL and create charged clients...but I may be wrong :) "

I hope I didn't give the impression that I am finding clients from LLL.  I keep my volunteer activities seperate from my professional work.  Most of the time the mothers do not know that I am an IBCLC and when they say something, I tell them I will help them as a LLL leader, since that is how we know each other or provide them with a list of IBCLCs to contact.  As a LLLL if a mom has a problem that requires close monitoring and is outside the scope of normal breastfeeding, I refer to IBCLCs.  As an IBCLC, I include free resources and bf support groups, especially LLL, in the mother's community for all my clients.

For long term supplement of revenue stream, I'd like to offer breastfeeding classes, but I'm not at the point where I feel like I need the additional revenue or that I can spare the additional time away from home.  

 "Very rarely are my reimbursements >1/4 or >1/3 of the original charge. Many are not reimbursed beyond the first visit since the insurance sees no medical necessity... which always makes me laugh as they truly have no idea that a problem with multiple issues can not be solved in one visit...but such is life."  

I agree that they have no idea the complexity and the amount of coordination involved in the care and follow up of these mothers and babies.  I love helping mothers and babies and therefore I go that extra mile to help- because I've been there.  

Thanks again for sharing your experience.  
Desiree Allison, BA (Anthropology-medical anthropology),  IBCLC, Arizona

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