Melinda, We do not bill ins. directly.

<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?>  I
understand some hospitals bill for a lactation consult. You can either have
the dr. order it, or you can bill for length of time you are with the
patient.

< Do you charge your inpatients for items like lanolin, gel pads, nipple
shells/shields, etc?  Who pays this? > Yes, we bill lanolin a tube from the
pharmacy, it is a pharmacy item. Gel pads, shields, and large flanges we
have a charge sheet we mark the charge item and the date, sign our name, and
put a pt sticker on the sheet and send down with daily charges. I'm not sure
how that gets paid, I guess it gets added on to the patient's bill?

<Do you collect payment directly from the patient?> No.

< What about when an inpatient needs a pump kit? > Kits are a charge item
off the central supply cart. /There is a sticker on the package and it gets
put on an index card with the pt i.d. sticker and goes with the daily
charges.See above for flanges.

<Do outpatient consults sign a consent?> No. I have an outpatient followup
appt form that I give the mom, it has her name, date and time of appt, and
name of LC she will see. It has lots of info about what happens at the appt,
sort of like a consent form. Email me at work if you want a copy I can
attach to email. I think it is a good form that I developed. In my opinion,
it will stand up to legal scrutiny as if the mom comes for the appt, then
she consents to it.
my work email is [log in to unmask]

 <Do you require a MD order to see an outpatient consult or are patient
requested consults accepted alone?>  Our docs are on board with the early
f/u visit, so it is standard procedure, it is offered to all bf moms. It
would be easy to add to routine admit orders, "if bf, have lactation
consultant see pt."
We also see pt requested consults, free. Virtually all consults are from the
pts who deliver with us, they might initially decline the f/u then call with
a problem or the baby looks yellow, or later if they have a problem. Maybe
once a year, or less, I'll have a mom who did not deliver with us, but heard
about me or something and wants a consult. That is fine.

At Methodist, before Katrina, we toyed with the idea of charges. My boss and
I felt that we did not want the prof. staff to handle money. Or keep money
on the unit. So we were thinking about having the mom check in and pay
cashier for the outpt visit or be billed like OT or PT would be. We were
going to do pump rentals becoz there was really a need for it in that area,
and we were going to send mom down with the paperwork, she would pay cashier
and come back up for the pump. We never did implement any of this becoz of
the hurricane. That hospital, as you know, never did come back.

Some hospitals have a gift shop and they refer moms to it (and other outlets
nearby so she has a choice) for bf aids or pumps or rentals. Many such
endeavors bring in quite a little income. Some are regular gift shops which
carry some lactation items, and some I know of are Mother/baby shops with
premie clothes, boppies, and all sorts of mom/baby things.

Hope this helps.
Laurie

Laurie Wheeler RN MN IBCLC
Mississippi USA

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