WHY HIRE AN IBCLC?
INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT is an important distinction because it represents the only credentialed lactation professional. An IBCLC has received training, accrued hundreds of hours of clinical experience, and passed an exam to become a certified health professional.
INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT is an important distinction because it represents the only credentialed lactation professional. An IBCLC has received training, accrued hundreds of hours of clinical experience, and passed an exam to become a certified health professional.
Catherine saved me! My daughter was in the NICU when she was first born and received formula feedings, but I really wanted to breastfeed. She gave me options and helped me forward. Catherine intuitively knew what I needed. CHRISTIE R.
YOUR RIGHTS UNDER THE LAW
The National Women's Law Center has developed a toolkit called New Benefits for Breastfeeding Moms: Facts and Tools to Understand Your Coverage under the Health Care Law.
The National Women's Law Center has developed a toolkit called New Benefits for Breastfeeding Moms: Facts and Tools to Understand Your Coverage under the Health Care Law.
AETNA IN-NETWORK VISITS
IIn Network with Aetna
Aetna has implemented significant changes to their lactation coverage. I aim to provide transparent and educational information to help you understand how Aetna processes claims for lactation services.
Key Concepts to Understand:
My Services:
I provide breastfeeding and lactation services in my Montclair, New Jersey office and limited home visits. While most Aetna plans cover my services, it's crucial to verify your specific coverage.
Booking and Billing Process:
FEE SCHEDULE
IIn Network with Aetna
Aetna has implemented significant changes to their lactation coverage. I aim to provide transparent and educational information to help you understand how Aetna processes claims for lactation services.
Key Concepts to Understand:
- Coverage now limited to 6 total billing codes per year (not 6 full consultations)
- Each consultation typically uses 2 codes (one for parent, one for baby)
- Effectively limits coverage to 3 consultations per year
- "Free" online classes or services through pump suppliers count against the 6 code limit
- Child's portion of the consult no longer covered as preventive care
- Potential out-of-pocket costs, even with 100% coverage stated by Aetna
- "Patient Responsibility" amounts determined by Aetna will be charged
My Services:
I provide breastfeeding and lactation services in my Montclair, New Jersey office and limited home visits. While most Aetna plans cover my services, it's crucial to verify your specific coverage.
Booking and Billing Process:
- Check your Aetna plan benefits before booking
- Provide credit card information during booking
- I submit claims and perform up to 2 rounds of appeals if necessary
- Any remaining balance will be charged to your card on file
- I encourage you to contact Aetna if coverage issues arise
- Reimbursements will be made if insurance later covers the visit
- Your insurance plan is a contract between you and Aetna
- Contact Aetna directly for specific coverage details
- Be aware of potential out-of-pocket costs (deductibles, coinsurance, copayments)
- "Covered" does not always mean "paid in full"
FEE SCHEDULE
Breastfeeding support is considered preventative and by law is a covered, but every plan differs and you need to know your own benefits.
OUT OF NETWORK
Keep in mind that you can be partially or totally reimbursed from your insurance company and that's up to you to determine. The price is inline with my level of expertise, education (which is significant to earn the board certification for lactation consulting) as well as all the time I spend on your care. I offer a bespoke service. Initial consultations are 90 minutes and follow ups are 60 minutes. What other health professional provides that level of time and attention? Our value is high and if you live in this metro area then you know that's the price of a super nice dinner or a massage at a spa, but with a lactation visit you get compassionate, expert help you feed your baby and peace of mind - both are priceless, imho.
TELL ME MORE ABOUT OUT OF NETWORK
Keep in mind that you can be partially or totally reimbursed from your insurance company and that's up to you to determine. The price is inline with my level of expertise, education (which is significant to earn the board certification for lactation consulting) as well as all the time I spend on your care. I offer a bespoke service. Initial consultations are 90 minutes and follow ups are 60 minutes. What other health professional provides that level of time and attention? Our value is high and if you live in this metro area then you know that's the price of a super nice dinner or a massage at a spa, but with a lactation visit you get compassionate, expert help you feed your baby and peace of mind - both are priceless, imho.
TELL ME MORE ABOUT OUT OF NETWORK
Pay out of pocket and attempt reimbursement:
You pay me directly for my services and I will provide a superbill to use to apply for potential reimbursement from your insurance company. A superbill is an itemized form, used by healthcare providers, which details services provided to a patient.
If they deny your claim, you resubmit it. When speaking to your insurance carrier for reimbursement, have your written benefits statement handy, take note of you who speak to, escalate to a supervisor or case manager if necessary and if all else fails you can make a complaint to NJDOBI or your local state board.
There is a script for calling your insurance carrier on page 8 of the Toolkit New Benefits for Breastfeeding Moms: Facts and Tools for Understanding Your Coverage under the Health Care Law
You pay me directly for my services and I will provide a superbill to use to apply for potential reimbursement from your insurance company. A superbill is an itemized form, used by healthcare providers, which details services provided to a patient.
If they deny your claim, you resubmit it. When speaking to your insurance carrier for reimbursement, have your written benefits statement handy, take note of you who speak to, escalate to a supervisor or case manager if necessary and if all else fails you can make a complaint to NJDOBI or your local state board.
There is a script for calling your insurance carrier on page 8 of the Toolkit New Benefits for Breastfeeding Moms: Facts and Tools for Understanding Your Coverage under the Health Care Law
HOW DO I GET STARTED?
Online scheduling is fast and easy
If you need more information before scheduling, message me with your questions.
Online scheduling is fast and easy
If you need more information before scheduling, message me with your questions.