I was asked what NYLCA has done so far in regards to assisting private practice IBCLCs to get reimbursement.  

First, one passive step is to require that anyone who lists services on our website is required to provide insurance forms to clients.   If anyone is caught not providing forms, they will be removed from our website until they do provide proper forms. 

Then a more active step.  One of our colleagues who is A lawyer, but not THE lawyer for NYLCA and now Vice President of NYLCA, spent months studying the insurance forms.  She also hired someone to work with her.  The end result of her study was that she was getting 95% coverage.  

She then did a small group five hour workshop to help private practice lactation consultants develop ALL their legal paperwork including health insurance.  The original plan was that this would be with private practitioners who are already practicing.  Actually ALL of our forms need improvement including my own.  We were going to share forms and then critique forms are rewrite them.  Instead, those who signed up were mostly new practitioners.  So it was not as interactive as planned since they had no paperwork yet.  They did however get a chance to look at mine and my forms were critiqued.   Participants were provided with the inner scoop on the details that make it more likely to get coverage.   The little details of how you fill out the forms can make or break the reimbursement and those details are state specific.  She certainly spotted room for improvement in my forms.

Other members have expressed interest in this workshop and I am sure it will only continue to improve over time.  

She is also developing an insurance template that members can download for a small fee and use to make their own forms.  They will also have to pay a small fee for downloadable updates. It will take a little more time to make this available.  

The lawyer IBCLC who is also planning on sitting through the webinars and analyzing opportunities to ensure we do get adequate reimbursement.  

Sincerely, 

Susan E Burger

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