Navigating insurance is confusing! When Allyson and I (Julie) first sat down to create Nurture Columbus, one of our main goals was to figure out insurance coverage and creative ways we could offer quality, in-home lactation services to ALL families. We have made some great progress working toward this goal, and are continually working each week to improve access to IBCLC lactation services. Here are your current options for covered or discounted services with Nurture:
- Nurture is in-network with the following non-Medicaid plans (Coinsurance/deductibles may apply):
- Medical Mutual
- Nurture is approved for out-of-network direct billing for OSU/Trustmark insurance plans with no out of pocket fees for members.
- For all other out-of-network insurance plans:
- Nurture will submit an insurance claim for you, if you provide your insurance information on your intake form. This means you self pay and we submit an insurance claim on your behalf requesting reimbursement. Any funds reimbursed will be sent to you directly from your insurance company.
- Use an HSA card/account to cover the expense of your vists.
- Consider requesting Gap Coverage or Network Deficiency. This means your insurance plan will bill an out-of-network provider as an in-network provider. If approved, you would pay Nurture directly as Self Pay, we submit an insurance claim to your company, and they reimburse you directly. We typically bill procedure code s9443 & 99404 and diagnosis code z39.1. Nurture does not submit paperwork or make calls for gap coverage at this time. Page 8 of this document provides a nice script for requesting lactation coverage: National Women’s Law Center Breastfeeding Tool Kit.
- Self Pay Rate is listed on our scheduling page and includes a 20% discount. Self Pay Rate clients pay in full, upfront upon completion of consultation.
- If you have a Medicaid plan or are a WIC recipient, in addition to advocating for lactation coverage, we offer a discounted consultation rate for all of our in-home and virtual consultation services. Discounted consultations cannot be submitted to insurance companies for reimbursement.
- If you would like to verify insurance coverage prior to your consultation, please call the number on the back of your insurance card to confirm. The following information may help in determining coverage:
Procedure Codes: S9443,99404, 99344, 96156
Diagnosis Codes: Z39.1, O9270, Z34.8 (prenatal)
Location Codes: 12 (in-home), 10 (telehealth)
Practitioner NPI numbers:
Allyson Wessells, PT, IBCLC
Angela Cleary, IBCLC
Joanne Erbe, RN, IBCLC
Julie Oberholzer, MPH, IBCLC
June Myers, IBCLC
Lisa Sheer, IBCLC
Melissa Courts, IBCLC
We hope one of these options helps you in accessing the care you deserve. We appreciate the opportunity to support you and your family on your feeding journey!
**This blog post is frequently updated to add up-to-date insurance coverage.
About the author: Julie Oberholzer is an International Board Certified Lactation Consultant (IBCLC) with Nurture Columbus, in Columbus, Ohio. With her background in Public Health and Lactation, she enjoys meeting with parents and new babies, helping them on their feeding journey and supporting them as they find their new normal.
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