There are various ways LCs can team up with medical practices.  I know a
very capable LC who works in an OB practice.  The docs provide her some
office space there and she is available to see their patients, but also has
some other private practice patients.  I have a nice arrangement with a
local, doctor owned HMO.  The group has over a hundred family practice,
pediatric, and OB docs, and they service quite a few big health plans.
About 4-5 yrs ago, they sent an inspector to check me out, review
credentials.  They wanted to see how my charting was done, made inquiry
about sanitation and sterilization technique, philosophy, etc.  We signed a
contract, and my role is that of an in-system specialist.  When any of the
docs in the group have a mother/baby with a lactation problem, the doctor
(not me) diagnoses this and they fax me a referral with an insurance
authorization number.  I see the patient, charge a co-pay,  and fill out the
superbill with the dx code the doctor has assigned (usually 'unspecified
disorder of lactation' or 'infant feeding problem').  I fax the doctor a
paragraph or two describing my observations and recommendations, and let
him/her know what follow-up is needed.  Then I send the superbill and my
invoice to the Group's billing office.  It takes months for the payment to
be processed, so the cash flow can be a problem unless you have lots of
bills in the pipe-line.  There is another LC also working in this capacity.
She is RN and gets more of the business because some of the insur. companies
like to work with RNs in the home care setting.  But it's a very workable
model, and the mothers are generally pleased with how easy it is for them
because they don't have to go out to an office visit.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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