Betsy Ayers wrote to ask about billing for in-hospital
services....

As for my own pay, I am paid by my
facility/corporation at an hourly rate for my work.
The LC's are currently paid on the same scale as the
RNs--in my happy dreams, we are paid using the
Advanced Practitioner scale, which would honor and
acknowledge the extra training and IBCLC title (and
responsibilities included therein).

For patient billing, we have a guide sheet with
rankings of the complexity of a consultation, and the
patient is billed according to that.  The rankings
are: minimal, focused, expanded, detailed, and
complex.  It is generally agreed by our team that the
TIME spent with a mom/baby pair is secondary to the
INTENSITY or COMPLEXITY of the teaching when
determining what type of consultation to bill for.  We
are in the process of refining and clarifying these
rankings to have more consistency in our billing (each
LC does her own).  The rates the patients are actually
charged for each type of consultation are different;
our manager quoted the numbers to us at last month's
staff meeting, and I about fell over, as the fees were
hefty.  All the more reason to try to help the
low-income moms while in hospital, when the insurance
will pick up the tab!  It makes me sick to think how
often the poor can get short-changed when it comes to
breastfeeding help.

Carole Jernigan
who is praying no one gets desperately sick this
winter, as we have--drum roll--no insurance!


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