Many insurance companies cover the costs of lactation visits. (If you ask me, ALL should!) I work with The Lactation Network (TLN), Wildflower Health and TriCare West to cover your visits with me! Most insurance companies do have a process for granting this access on a case by case basis called a Waiver or GAP coverage IF they don't have a listed IBCLC within their network (& most don't!) Steps for Filing for GAP Coverage or a Waiver can be found HERE
I am a sub-contracted IBCLC through The Lactation Network/Ashland Health. (TLN) TLN acts as the primary provider for many Blue Cross Blue Shield and Anthem PPO insurance plans.
You can submit an inquiry for coverage HERE. Approved inquiries will receive an email with a request to sign an Assignment of Benefits (AOB) form which allows them to bill your insurance company. IF not signed prior to our appointment, payments due will be your responsibility and due at time of service. If approved, your email will indicate the number of approved appointments (usually 6 though we can request more if needed) and there will be no out of pocket costs for the pre-approved visits. If additional visits are not approved, TLN will bill you directly.
I am a sub-contracted IBCLC through Wildflower Health for all Cigna Insurance plans. You can submit an inquiry for coverage HERE. If approved, your email will indicate the number of approved appointments. If additional visits are not approved, additional appointments will convert to Self-Pay appointments.
Tricare West / Humana Healthcare
I am an approved NON network provider for Tricare West/ Humana Healthcare. You can submit a referral request via Tricare for an appointment with me. You may be asked to provide my name and NPI number (Heather Martin/1952649311) Approved inquiries will receive an email or phone call prior to your ability to schedule directly. This may take 24 - 72 hours at a minimum. For appointments, payments will need to be paid at time of service or prior. I will provide a Superbill for reimbursement purposes at the end of our appointment in addition to copies of your Care Plan.
Self-Pay Visits
IF your Insurance Company is not in network, that's okay, I'll provide you with an itemized receipt that can be submitted for reimbursement.
Self-pay patients will be provided an itemized statement that can be submitted to your insurance company or health share plan for reimbursement purposes. Initial Visits are 90-120 minutes of tender, detailed care learning about you and your family. Let’s dig into your current issues and top concerns and develop a customized care plan that helps you meet your goals. Referrals if needed will be shared along with resources. Follow-Up Visits are 45-90 minutes of addressing any new concerns along as well as checking on your progress/changes since our first visit. Depending on what you or your baby are experiencing, you may need more than one visit to address concerns and work towards improvements. All visits include a detailed assessment, weight check and personalized Care Plan.
For self-pay rate is: $165 initial office visit $135 follow-up office visits $195 initial home visit $145 follow-up home visit $95 virtual visits