Diagnosis codes on health insurance forms are there for purposes of
establishing legitimate rights to receive payment.  They are not there to
"establish" the medical diagnosis -- which, indeed, IBCLCs cannot provide.

Insurance companies use lots of words that we use -- but it is part of
their unique insurance lexicon.  One big company "certifies" IBCLCs to be
part of their pool of approved caregivers.  What they mean by
"certification" is a whole different kettle of fish that what IBLCE means
by my "certification" to be an IBCLC.

It is common in the USA for insurance companies to only reimburse care
provided by (or at the direction of) a licensed healthcare providers.
IBCLCs are thus "frozen out."

It is common in the USA for insurance companies to deny deny deny
legitimate payments, hoping to wear down individual and their healthcare
providers. Me throwing in the towel on $50 that is not worth the *dozens*
of hours it will take me to collect it only costs me $50.  But when the
insurance companies do this hundreds of thousands of times a day, you can
see why it is a profitable business model for THEM.

The California-based parent and/or IBCLC should check out the CA
Breastfeeding Coalition page for resources and support to fight this denial
of coverage.  California often has protections under the law that are
*better* than for other states, or the nation as a whole.
http://californiabreastfeeding.org/breastfeedingrights/

This is a lovely plain-English explanation of the whole sordid sorry
insurance coverage mess we must deal with here in the USA:
https://www.verywellhealth.com/learn-about-insurance-codes-to-avoid-billing-errors-1738628


-- 
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA
U. S. Breastfeeding Committee: CRASH, Nominations, Membership, Donor Milk

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