Dear Arly,

I am sending this to you via everyone since your insurance question has been
asked of me multiple times.

We provide lactation support and services through a hospital based lactation
center.  Our outpatient services are handled as any other hospital service.  The
patient makes an appointment with the ibclc.  At her appointment time she checks
in with our admitting office in outpatient services and comes to the lactation
center for her consultation.  After she leaves, the ibclc checks off service
time and any equipment used and sends this form to the secretary for billing to
insurance company.

Our services are reimbursed from both private insurers and from government
(Medicaid).  The rate of reimbursement varies from plan to plan and from state
to state.  Private insurance generally reimburses well, many over 92% and all
that I have checked are over 50%.  Medicaid reimburses 44% if NC and 15% if SC.

Our service is considered remedy for a medical condition.  We always dictate a
report following the patient visit, and a copy of this dictation lives in
medical records, a copy in our lactation center files, and a copy is sent to
each involved physician (ob & ped or fp).

Hope this is helpful.  I would like to hear what others are doing in this area.
 Any suggestions on increasing reimbursement rates,  especially for Medicaid?


Pardee H. Hinson, MPH, IBCLC
Charlotte, NC      [log in to unmask]