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Old December 14th 03, 05:58 PM
CY
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Default lactation consultant?

You can find one at http://www.breastfeeding.com/directory/lcdirectory.html
or look in your local yellow pages under "breastfeeding" or "baby".

Having worked for both a lactation consultant and a health insurance
company, I can tell you that often LC's are not *initially* covered because
a) they are not "in-network" and b) insurance carriers generally deny it
first time around as a "gatekeeper" procedure.

Also when you call them they will say that it is NOT covered (about 99% of
time). So, what you generally have to do is, call them first and see if by
a remote miracle it is covered, and if so get the name of an in network
provider. Otherwise, go to one and pay out of pocket, or find one that
direct bills insurance companies (a better option since they often know how
to code the bill to better get payment). If you pay out of pocket, ask for
a receipt with ICD9 codes and diagnosis codes then submit it yourself to
your claims address on the back of your membership card. It will (most
likely) get denied but then they will send you information about how to
appeal. If you can get a referral by your pediatrician/ob/midwife this will
help it get paid too. Generally once you appeal, you will be put in touch
with a real person assigned to your case and it will probably take 2 or 3
times to get it paid, so don't get discouraged and keep resubmitting it - if
you can get your doc to talk to them this is another helpful thing (though
most don't have time). More & more ins co's are paying now (Cigna & UHC
among the better ones). LCs are so worth the money if you get a good one.
Ensure she is an IBCLC and not a Lactation nurse. In my area, an LC runs
about $60-$70 an hour, which is only the price of about 3 weeks of formula,
so seeing one to protect the bf'ing relationship is worth it.

HTH,
CY


"K.B." wrote in message
k.net...
How do I find one and does insurance usually cover one?
Kris