Insurance?

One of the most common questions we get asked at The Pump Connection is whether or not we bill for insurance. We know that insurance coverage can be confusing and although we do not directly bill for insurance reimbursement, it is important to know that the Affordable Care Act actually requires that insurance companies cover breastfeeding support and supplies to some extent.

The provision actually states: “Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment.” Each health care insurance company has outlined the breastfeeding services and support that is covered, so we recommend you check with your health plan and get more specifics on what is covered for you. It’s also common to get reimbursed for these services by submitting a claim after the service or purchase has taken place.

During your visit we can provide you with a "Superbill" that you can submit to your insurance company for possible reimbursement for your lactation consultations and/or breast pump rental. Each insurance company is different and each individual's policy may or may not include coverage for these items. Again, we strongly encourage you to check with your insurance company PRIOR to your visit.

Your physician or your baby's physician can write a referral or "prescription" for lactation visits and a diagnosis. This does help with reimbursement. Each lactation visit is on a separate Superbill and will be written for either you or your baby. The lactation consultant will determine who is the primary patient for each visit.

Breast pumps may be covered under DME (Durable Medical Equipment). If requested, The Pump Connection will provide a Superbill for each month a pump is rented. The pump rental and Superbill is written in mother's name, since she is the one using the breast pump. A doctor's note may also improve the chances for reimbursement for breast pump rentals.

Lastly, many insurance companies initially turn down a claim. Experience has proven that resubmitting the claim may possibly result in a payment.

 

**Please feel free to contact us with any additional questions.