lactation

What is a super bill and what do I do with it?

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What is a SUPER BILL and how do I get coverage through my insurance if I was denied through TLN or Wildflower?

First, you pay at the time of your visit for our services (you can use cash/check/card/FSA/HAS) and we can provide you with an official receipt called a “super bill” that you can use for potential reimbursement from your insurance company or medishare plan.     

This link describes what your breastfeeding coverage is under the Affordable Care Act: https://nwlc.org/resource/breastfeeding-benefits-understanding-your-coverage-under-the-affordable-care-act/

Here are things you can do and questions you can ask your insurance carrier PRIOR TO your appointment to potentially have your insurance reimburse you.  This may involve getting preauthorization.

  • What is my coverage for out-of-network Lactation services?
  • Is my provider required to be credentialed as an out-of-network provider for me to receive reimbursement? If yes, please find out exactly what they need from us, and where to fax it, and let Morgan or your IBCLC know.
  • Does my insurance exclude home visits for lactation services (location code 12)?
  • Do I have a co-payment or is there a percentage of the bill I will be responsible for?
  • Does my plan require a deductible to be paid for the calendar year before the coverage begins? If so, what is the dollar amount and how much of my deductible have I already met?
  • Does my insurance plan only cover a limited number of sessions for each calendar year?
  • Is there a fax number I can use to submit superbills? If not, what address should be used?  * When submitting superbills to insurance please be sure to specify that you would like direct reimbursement.
  • Is there an additional form to be submitted with superbills?
  • If your insurance carrier has no in-network lactation consultant (IBCLC) that provides private lactation consults, you can petition that they pre-authorize us as an in-network providers. You can try to get a pre-authorization for your consults, but you must do this beforehand by requesting a “gap exception” or an “in-for-out”. Request that this be expedited. Write everything down — who you spoke with, case number and the authorization number. Ask that you be sent confirmation in writing. (Even with a pre-authorization, you will still pay up-front and request reimbursement from your insurance company.)
  • The typical procedure codes we use are s9443 or 99404,  so find out which is acceptable, or if there are other codes they would like us to use. The diagnosis code used is z39.1 (Maternal Lactation Care).
  • Practitioner information you might need when you call your insurance:
    •  Business name: Lactation Care with Elizabeth. 
    • Company NPI: 1881291144
    • Company EIN: 81-2896336

Milk Donation Pick Up How-To

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Lexington, KY Milk Express & Milk Depot for The Milk Bank

We are privileged to partner with The Milk Bank to serve as a local Milk Express & a Milk Depot. We can accept donations from registered and approved donors through The Milk Bank. We also dispense purchased pasteurized human milk on behalf of The Milk Bank as well. Check out the steps to take to be sure you can collect your milk as easily and efficiently as possible.

For any additional assistance with feeding babies, please check out the blog, or schedule an appointment with one of our board certified lactation consultants. Insurance coverage an option, check coverage first before scheduling appointment on our Services page. For other support groups and group classes, view the schedule on our Classes page.

Real Client, Real Experience

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Received from a current client as of January 2022:

“I’ve been so thrilled with my experience 
with Elizabeth (and Katie) I would be glad to sing their praises any time!

Going in, I thought a lactation consultant would just show you how to 
hold the baby properly and ensure a good latch, I didn’t know enough to 
even realize there could be more to learn. We’ve gotten so much more 
than that; Elizabeth has been so compassionate and encouraging; in 
talking over our problems, we always feel she’s part therapist for us, lol.

We didn’t realize that appointments would include before and after weigh 
ins for the baby, which has been such a reassurance. When breastfeeding, 
it’s kind of hair raising to not know how much food your baby is 
actually getting. Having that info was such a relief.

Having someone inspect his mouth, gauge the strength of his suck, and 
tongue action, etc, was something I didn’t realize could even be 
examined, and knowing that he doesn’t have any problems in those 
departments was also a relief; I’d say the same if she DID find 
problems, knowing is half the battle, after all.

She’s helped put to bed many of our anxieties about handwashing, green 
diapers, spit up, and some medical misconceptions (I had been worried 
that letting him comfort nurse would stimulate my body to keep producing 
more milk, but she explained that it’s a different sucking pattern and 
my body knows to ignore that in terms of milk production). Elizabeth has 
also given my husband pointers for bottle feeding, and advice on different 
nipple styles, and even a new nipple to test drive at home. In my mind, 
I thought a lactation consultant would cover breastfeeding alone; if we 
had gone with formula or exclusive bottle feeding of breastmilk, we 
never would have even thought about seeking out a lactation consultant. 
I imagine there are others like that too, who think this type of service 
is for the breast-fed baby alone.

Sometimes just watching how Elizabeth handles the baby has been so 
helpful too. Perhaps like many first time parents, we’ve been handling 
him like glass, so to see someone handle him more freely and confidently 
helped us realize he’s stronger than we think, and we have more freedom 
in how we hold him too. She’s also taught us new ways to hold him, and 
burp him, that have brought us a lot of success compared to the standard 
techniques we were shown in the hospital. She’s also given us ways to 
help strengthen his tongue function, like tracing our finger around his 
gums, and sweeping around on his soft palate and pushing down on his tongue.

Connecting with Katie has also been wonderful; we wouldn’t have even 
been aware such services existed if we hadn’t met her by chance at our 
first appointment with Elizabeth. In the same way, Katie handles the 
baby so confidently and effortlessly that we’re reminded we can handle 
him more freely too. And many of the exercises she has done with him are 
things we’ve been able to replicate at home as well (some different 
stretches, nothing with his skull, haha). He enjoys all the new touches!

Perhaps we’re just particularly hungry for confident 
familial energy to help guide us through this time and both Elizabeth 
and Katie have that kind of warmth and positivity. We’ll be sad when 
Emmery stops breastfeeding and we no longer have an excuse to go.”

WE couldn’t ask for a better overview that touches on some (still not all) aspects of lactation support as practiced at Lactation Care with Elizabeth. A wholistic, family approach includes much more than a latch. And seeking help from an IBCLC affords expert advice on many aspects of lactation, feeding, structure and development.

Within the safe space of lactation support, processing and healing occur, both mental and physical. We are thankful for other professionals we include in our care for clients and love to hear about the progress made outside of our office. Thanks to our client for the kind words and personal examples of her experience with breastfeeding support!

Look what is new!

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We have the joy of doing what we love here at Lactation Care with Elizabeth. And we found others that love it too! Over the past several months, as many of you already know, we have added to our team. We love our clients and want to be available as needed. More clients, clients having babies, babies having procedures, life changes, and so forth meant adding fantastic IBCLCs to the rotation so we really can meet you where you are on your breastfeeding journey.

We want you to meet the new members of the team and get to know them. At Lactation Care with Elizabeth, we love getting to know our clients – both parents and baby – and seeing into such an important part of your lives. Read more about the ladies on our website: http://www.lactationcarewithelizabeth.com/about.

Our newest members to the Lactation Care with Elizabeth team!