Dear Friends:
     This is for US lactation specialists in private practice. Have you seen
any change in your referrals since the HIPPA regulations went into effect?
     I have been kicked out of the BlueCross/Blue Shield network, as there is
now no billing code for private practice lactation consultation. The only way
to be reimbursed now is to be part of a home health agency or a hospital
based program. I know a professional that has joined with a home health agency in
exchange for a small fee. The home health agency does the billing; the
lactation specialist takes less money for the consult in order to be able to do the
work. As 70% of the people in my area belong to some sort of BlueCross/Blue
Shield program, this seems to be the only way to survive and I am considering it
myself. Any income is better than none.
     When I called the phone numbers given to my by the HMO that had
contracted with me to appeal this dismal state of events by talking with the folks
from HIPPA, they were both dummy numbers.
     What is going on in the rest of the country?
     warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CIMI, CCE, craniosacral therapy
Adjunct faculty, Union Institute and University, Maternal and Child Health:
Lactation Consulting
Supporting the WHO Code and the Mother Friendly Childbirth Initiative

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