We know that there are so many questions concerning Lactation Service Coverage.  We hope you find this page helpful in answering your inquiries.

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What payment methods are accepted by Lactation Love:

Currently we accept, PayPal, Cash, or Check (Square payments coming soon!) Payment is due at the time of service.  

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Does Lactation Love accept insurance?

Lactation Love  is not an in-network provider with any insurance company. This means we do not handle filling claims with your health plan. We are happy to provide you with a coded receipt for services (i.e. Superbill) and information for filling for insurance reimbursement. If your insurance policy covers the cost of our services, they will reimburse you, not us.

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Am I guaranteed reimbursement for lactation visits or breastfeeding classes from my insurance company?

We cannot guarantee reimbursement from any insurance company. It’s always smart to call your insurance company for the most up-to-date information and to find out what lactation services may be covered under your health plan. Some insurance companies only cover breastfeeding education and support provided by in-network providers. (It is important for you to know that there are NO in-network lactation consultants outside of the hospitals in many areas) Other insurance companies may cover lactation services from out-of-network providers in instances where the insurance company does not have a provider within a certain amount of miles (typically 30) for a service that they are required to cover. (Be sure to ask your insurance company if they have any in-network providers in your area. And if not, whether they will cover lactation visits with an out-of-network provider such as Lactation Love.) 

Insurance companies are required to cover lactation consultations under the Affordable Care Act (ACA). A “gap exception” can help facilitate your full reimbursement when going to an out-of-network provider like Lactation Love. Plans that do not have in-network providers available to you MUST cover out-of-network providers as though they were in-network.

While insurance companies are required to provide lactation services under the ACA, many require “precertification” “prior-authorization” or “preauthorization” or a referral from a physician. If reimbursement is important to you, we recommend you call your insurance company prior to your appointment to determine your coverage for in-home lactation visits or prenatal breastfeeding education classes and consultations. BEFORE calling insurance, we also recommend you thoroughly review this toolkit from the National Women’s Law Center to understand what the law requires your insurance company to cover and how. Sometimes we find that insurance company representatives are not fully aware of ACA’s provisions regarding breastfeeding care. If the representative you speak to initially denies coverage, ask to speak to another representative or supervisor who is more knowledgeable about your right to breastfeeding help from a qualified provider.

Some of our clients have shared that their insurance company approved as many as 6 in-home visits with Lactation Love with no out-of-pocket deductible or co-pay. These insurance companies include:

Aetna
Humana
Blue Cross Blue Shield of Florida

 

What is “precertification,” “prior-authorization,” or “preauthorization,” and how do I get it?

Preauthorization is the process of getting approval from your health plan before you have any health procedures performed. This is usually needed for home health care services such as in-home lactation visits.

To secure preauthorization, you will just need to call your insurance company (the number is on the back of your member ID card), tell them you have an appointment scheduled with us, and check to see what information they need.

 

Some of our clients have found this information helpful when seeking reimbursement for lactation visits:

Our Company Name: Lactation Love, LLC

Our Address: 700 Eaglenook Way, Osprey, FL 34229

Our Phone Number: 941-451-7684

Our Federal Tax ID: 81-3171793

Our Billing NPI: 1568814069

Our Procedural Codes for in-home lactation visits: 99404 (place of service 12) and ICD-10 Z39.1

Our Procedural Codes for individual (in-home) prenatal breastfeeding education classes: S9443 (place of service 12)

Our Procedural Codes for group prenatal breastfeeding education classes: S9443 (place of service 11)

 

How do I schedule an appointment?

Please call or text us at 941-451-7684 to schedule an appointment or for more information. We offer next day appointments 7 days/week from 8am – 8pm! Additionally, we are sometimes able to work in clients the very same day. Please call or email us today at LactationLoveCLC@gmail.com if you have an urgent need for breastfeeding help.

We’re open nights, weekends, and holidays because we all know, BREASTFEEDING CAN’T WAIT!

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