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Lactation Information and Discussion

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Subject:
From:
Kathleen Gale <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 3 Jul 2010 00:29:21 -0400
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Hi! This is my first post on Lactnet. 

 Hope it goes to the right place.  I think you are probably asking about malpractice insurance...I have questions regarding getting insurance reimbursement for my private ciients.  

 I looked into becoming a "preferred provider" with Blue Cross Blue Shield, but found that it wouldn't really benefit me or my clients.  If I became a preferred provider, that would mean that I would have to do all the paper work and wait for whatever compensation the insurance might give me, and then deal with trying to collect from the client if insurance didn't pay.  

Instead, I give my clients a superbill with the visit codes marked, the time, the cost, the diagnosis...and I tell them how to go about submitting their claim to their insurance company.

I found that they will usually not cover a "lactation consultation", as they put that under the category of education or counseling.  Since I am an RN, when I do my initial phone call with patients, I recommend to them that they call their pediatricians office, talk to the nurse, and request a physicians order for a "Skilled Nursing Visit for Newborn Feeding Concerns".  This puts it in the skilled nursing realm, and insurance often will cover it.  They don't need that order for me, but it should be requested before my visit,and it can be put in their chart to pick up the next time they go in.

I recently did a survey of my clients to try and discover what type of coverage they were getting from insurance.  I had a small response, but it seems that with Blue Cross/Blue Shield and a few other insurance companies, this method works, and they reimburse either all or at least a portion of the cost of the visit.

I would love to get more information from others on what they have found to be the most effective method to help clients get some insurance coverage.

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