Utica Lactation Consultant Insurance Coverage Billing

Insurance and fees

If you have one of these plans:

Excellus BCBS PPO Other Blue Cross Blue Shield PPO Anthem BCBS PPO Cigna PPO Humana PPO/POS Any Plan with Multiplan or Provider Network of America logos

Please submit your insurance information to my billing partner, The Lactation Network. If you are preapproved through The Lactation Network, or TLN, you are covered with no out-of-pocket expense. Both in-person and telehealth visits are covered. Please verify your coverage below, before scheduling your visit.

Please text me at 315-497-7080 if you’re experiencing difficulties with this step or didn’t receive confirmation email within 24 business hours.

If you are covered under AETNA insurance:

I’m now in network provider and can bill your insurance. Many plans will reimburse 6 lactation visits with no out of packet cost for you. You will be responsible to cover any charges Aetna chooses not to pay.

If you are covered under TRICARE insurance:

I recently became a Tricare authorized provider. I am a non-network provider for the East Region. I have the ability to file your claim and NO payment is due at the time of service when service occurs in my office. Humana Military allows for 6 consultations per birth.

If TLN can’t bill your isurance plan, or you have insurance other then those listed above, I will accept your payment at the time of your consultation. I will then provide you with a receipt including billing codes needed when you seek reimbursement.

My fees are all HSA/FSA eligible expenses. I accept HSA cards, credit/debit, check or cash.

My self pay client fees are:

Initial Visit: $208
Follow up Visit: $182
Prenatal Class:$156

Please don’t let financial difficulties defer your form seeking help. A limited number of discounted visits are available as needed.

Are you looking for a perfect last minute gift. Do you have a loved one who is breastfeeding or planing to breastfeed and need some help and encouragement. You can give them a one on one time with lactation consultant, virtual consultation or prenatal breastfeeding class. You can choose any amount from $25 to $500. It can make a world of difference to the experience of a new mother.

I don't quality for a free lactation visits through Lactation Network, can I still seek reimbursement from my insurance?

The Affordable Care Act of 2012 requires most health insurance companies to cover “breastfeeding support, supplies and counseling” in conjunction with each birth. This means that most insurance companies should cover a home visit from an IBCLC.

Although I can’t charge your insurance directly, I will provide you with a “superbill” to submit to your insurance for reimbursement. I can not guarantee you will be reimbursed since each insurance plan is different. I recommend you call your insurance provider in advance of our appointment to check your plan’s reimbursement policy and ask about seeing an out of network lactation consultant.

This toolkit will provide much-needed information about the laws, how to talk to your insurance resentative and steps to take to receive reimbursement. I encourage you to contact your insurance company to ask about the coverage and to seek authorization. Toolkit

You might be wondering if the Lactation Consultation is too pricey. Consider reading this article by Best for Babes. Article