Insurance Information for Lactation Consultations
Beginning January 12, 2023 South Bay Baby Care will be utilizing The Lactation Network (TLN) to provide insurance-covered lactation & infant feeding services to more patients!
If you have PPO insurance through one of the following insurance carriers you may qualify for 6 insurance-covered In-home and/or Telehealth Lactation/Infant Feeding Consultations!
PPO insurance carriers: Blue Cross Blue Shield, Anthem, Cigna, Humana, Provider Network of America (PNOA) and MultiPlan (which may cover insurance carriers such as Aeta, Blue Shield, United Healthcare and more).
To determine if your insurance is covered please use this link or scan the QR code:
Once pre-approval has been received your appointment may be scheduled. If you do not receive pre-approval you have the option to schedule your appointment as a cash-pay patient (see below).
Initial consultations through TLN are 90 minutes in duration. Any follow-up concerns can be addressed via a follow-up in home and/or telehealth consultation. A convenience fee will apply for in-home consultations to cover travel time and costs that are not covered by insurance.
Please contact email@example.com for more information releated to services provided utizliing TLN.
Any questions relating to insurance should be addressed with TLN at firstname.lastname@example.org.
Self-pay + Superbill
For patients that do not qualify for coverage through TLN, I offer cash-pay services that may be insurance reimbursable. I am a CMS recognized provider and I have CPT and ICD-10 codes for RN & IBCLC services provided for educational and care services related to perinatal, newborn and breastfeeding/lactation visits. Upon request I can supply you with a superbill once your services have been paid in full and you can submit the superbill to your insurance to request reimbursement. South Bay Baby Care is out-of-network with all insurance providers. I cannot guarantee insurance reimbursement. If your insurance company denies payment I am happy to provide an appeal letter to be submitted. Service fees are due at the time that services are rendered.
If you would like to contact your insurance in advance to determine if services with South Bay Baby Care are reimbursable and what your policy's reimbursement rate it is, you may need to provide the following information:
South Bay Baby Care Nursing Services, Inc.
South Bay Baby Care NPI: 1023507597
Lisa Grossman RN, IBCLC NPI: 1669186441
South Bay Baby Care EIN/ Tax ID: 82-5139960
CA BRN Registered Nurse License Number: 827047
IBCLC ID: L-163653
Insurance coverage related to Before Baby Prenatal Education Consultations is plan-specific. Please contact the member benefits number on the back of your insurance card to determine if your plan may reimburse for these services. Some insurance companies or plans may require pre-approval or authorization for partial or full reimbursement. I am happy to complete pre-approval paperwork as required by your policy.
HSA or FSA reimbursement
I am a CMS recognized provider and I have CPT and ICD-10 codes for RN & IBCLC services provided for educational and care services related to perinatal, newborn and breastfeeding/lactation visits. Upon request I can supply you with a superbill once your services have been paid in full and you can submit the superbill to your HSA or FSA plan to request reimbursement. I cannot guarantee reimbursement as each plan is different; however, the majority of my clients have not had issues with HSA or FSA reimbursement for RN services covering perinatal, newborn and lactation/infant feeding consultations.
To schedule a Lactation Consultation or After Baby session, please email email@example.com.
I will respond to your message as soon as possible. For all requests please be sure to include:
1) Your first name
2) Baby's age
5) Availability & urgency
6) If you were referred by a Pediatrician, Doctor, Dentist or other medical professional
7) Any additional pertinent information