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Billing for a lactation Consultant

We do not have lactation services available in our area. Recently a
certified lactation consultant moved to the area and would like to begin
providing services as well as be paid for them. I'd like to facilitate this
but do not want to subsidize this service.
Is there a way that she could fund herself? How do others get paid for these
services - in the hospital as well as through home visits or the office?
I want to insist that she visit the new moms in the hospital - is this
reasonable? I do not see the usefulness of an initial visit at 3-5 days of
age.
-graham

Billing for a lactation Consultant

On Nov 29, 2006, at 7:14 PM, wrote:

> How do others get paid for these
> services - in the hospital as well as through home visits or the
> office?

In my town, the LC's are nurses on the OB floor, and hospital
employees. They see all the moms that want to nurse, every day while
in house. If I want to send a mom/baby to see the LC, the mother's
insurance is billed for the service, even as the baby gets older, or
at least that is my understanding.

I know that I confirmed that having the mom see the LC the second or
third day after discharge will be charged to the mom's insurance and
won't affect my payment for a post-hospital new baby visit in the
office. As a breast-feeding mom myself, I like to see the babies a
few days after discharge, mostly to encourage the mom to stick with
it. One or two of my colleagues tend not to see the baby after
discharge until the two week visit.

I'm not sure if the LC's are completely supported by their LC work--
it seems that they function as regular OB nurses as well. I think
that in our area a hospital has to have an LC service to compete for
business.

Julia in Wisconsin

P.S. come on, hasn't anybody taken the ABP recertification exam?

Billing for a lactation Consultant

In a message dated 11/29/2006 8:03:10 P.M. Central Standard Time,
hidden@email-address writes:

I'd like to facilitate this
but do not want to subsidize this service.
Is there a way that she could fund herself? How do others get paid for these
services - in the hospital as well as through home visits or the office?
I want to insist that she visit the new moms in the hospital - is this
reasonable? I do not see the usefulness of an initial visit at 3-5 days of
age.

Hi Graham,

I'm an IBCLC and work for a pediatric group. I've been with them for nearly
19 years, and they pay me for the work I do. They bill the insurance
company for my hospital visits and also my followup visits. If the insurance
company doesn't reimburse them for my hospital visit, the office "eats" it. If it
doesn't reimburse them for a follow-up visit, the patient pays whatever
insurance doesn't cover.

The problem is billing a mom for a lactation visit in the hospital when she
didn't request it. A lot of moms don't know that they need a visit, and by
the time they figure it out, it may be too late to see them, given early
discharge.

Perhaps you could facilitate this LC getting hired by the hospital and paid
by them to see all the moms in the hospital and set up an outpatient setting
where she could see them after discharge if need be? That way it would be
part of the services the hospital offers -- perhaps along w/ pump rentals --
and then some of her costs could be subsidized by pump rentals and outpatient
lactation visits that would be billed to insurance. The hardest thing is
getting reimbursement for inpatient lactation visits, though some hospitals are
able to do it.

The hospital where I see moms and babies has a lactation service as well.
They don't bill for inpatient, but they do bill for outpatient. Our hospital
does about 3600 deliveries a year. There are now two IBCLCs that work with
two different pediatric practices and see moms in the hospital. The other one
just started -- as I said, I've been doing this with our practice for nearly
19 years -- our practice has gone from one pediatrician to seven, plus two
pediatric nurse practitioners.

I work out of my home as when I started, the office was too small to
accommodate me -- I have an office in my home, and if I need to see moms on
follow-up they see me here.

Hope that helps!

Jan, RN, MA, IBCLC

_Lactation Education Consultants_
(http://www.lactationeducationconsultants.com/)

billing for a lactation consultant

Hi fellow partner talker's.
We now have a licensed lactation consultant on staff.
I am trying to figure out how to go about billing for her services. She
is an RN and lactation consultant.
We are here in Pennsylvania. I have seen conflicting information.
I appreciate any and all help. Thank you!

Jayme
Hershey Pediatric Center
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