The Lactation Network covers lactation visits in full for many.

Check Insurance Coverage Here

I believe that lactation support is a worthy investment for your family. Formula can cost up to $600 a month, while breastfeeding is lower cost feeding method. And after witnessing the recent and concerning formula shortage in this country, I am sure you can agree that the comfort of breastfeeding, is invaluable. For those who are formula feeding, the peace of mind that comes with improved infant feeding is priceless.

I do not currently participate in-network with any insurance plans. However, I am happy to provide the following resources to help guide you through the processes of receiving a reimbursement.  

The Lactation Network covers visits for many.

Check Your Insurance coverage Here

Payment is due at the time of service. I am private pay, but your visit may be covered through the lactation network.

I accept cash, checks, credit cards and HSA and FSA cards. A travel fee applies for home visits outside of a 5 mile radius from 29466. A cancellation policy applies for any appointments canceled with less than 24 hours notice. 

What if I need to cancel my appointment?

You may cancel your appointment up to 24 hours in advance of your appointment via the booking widget. I also offer virtual visits as an alternative.

Superbill

At parents request, I offer superbills.  If you’d like to submit a claim for out-of-network reimbursement, I will provide you with a statement, which you can send to your insurance company. 

You are entitled to reimbursement for lactation services through:

Affordable Care Act

The 2010 Affordable Care Act states that insurance should cover: “comprehensive lactation support services (including counseling, education, and breastfeeding equipment and supplies) during the antenatal, perinatal, and postpartum periods to ensure the successful initiation and maintenance of breastfeeding.”  

This means that unless you have a health insurance plan that is “grandfathered in,” your insurance company must pay for lactation support for the duration of breastfeeding (not just while you’re in the postpartum ward at the hospital).

Preauthorization

You may improve your chances of reimbursement if you request preauthorization for lactation support from insurance prior to submitting your claim.  

Lactation Support Referral

It may also be helpful to obtain a referral for lactation support from your baby’s pediatrician or from your obstetrician.

Out-of-Network Exemption

Also included in the Affordable Care Act is the Out-of-Network Exemption or Network Gap Exemption. This states that “if a plan or issuer does not have in its network a provider who can provide the particular service, then the plan or issuer must cover the item or service when performed by an out-of-network provider and not impose cost-sharing with respect to the item or service.”

If your insurance does not participate in-network with any lactation consultants within a reasonable distance, you may petition to receive lactation services at an in-network rate. Be sure to apply for this exemption prior to our visit otherwise the claim will be processed as out-of-network. You should also request several visits as this is typically only a one-time temporary exemption.

To complete this request, you may be asked for the following information:

·      Provider Name:

·      NPI #

·      EIN #

·      Provider Address:

·      Provider Phone:

·      Diagnosis Code:

·      Procedural Codes:

·      Date range of requested lactation support:

OR CONTACT ME FOR REFERRAL FORM

When speaking to an insurance representative on the phone, always note his/her name, date, and reference number of the call so that you can refer back to it if necessary.

NEW BENEFITS FOR BREASTFEEDING MOMS TOOLKIT

 For more information about the types of lactation support insurance plans are required to cover, please download the National Women’s Law Center Breastfeeding Toolkit. This great resource will help you better understand the lactation support you are entitled to, as well as a script to use when calling your insurance company to inquire about coverage.

If you have any questions during this process, you can call the National Women’s Law Service directly at 1-866-PILL4US or email them at pill4us@nwlc.org. text goes here

Travel fees apply to home visits if its beyond a 15 minute drive from the mount pleasant public library.

Travel fees are as follows:

• 0-15 minutes- None

• 15 - 30 Minutes - $30

• 30 - 45 minutes - $90

• 45 - 60 minutes - $160

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