We are able to accept most Cigna PPO, Anthem PPO and and Blue Cross Blue Shield PPO plans for lactation and infant feeding services only. All other services are considered out of network with insurance.
For those seeking lactation and infant feeding services who do not have one of these plans, you would be considered self pay and will be provided with a detailed invoice that is called a superbill to submit to your insurance for your direct reimbursement. Here’s some information about the process:
- Under the Affordable Care Act, lactation and infant feeding services should be covered in or out of network (see below Insurance Exception details below when they are not), information about benefits can be found here and here.
- Usually for self pay/out of network session, 60-70% is reimbursed back to you. We will provide you a superbill for your visit which you’ll be able to submit for reimbursement by following the instructions your insurance provides to you (usually on the back of your card or on their website). NOTE: We cannot guarantee that you will be reimbursed as insurance reimbursement depends on your plan, your deductible, and the contracted reimbursement rate. If you are concerned about reimbursement, please call your insurance provider for more information with the following details:
Provider: Nina Chanpreet Kaur
Provider Credentials: IBCLC
CPT Code: S9443*
Diagnosis Code: Z39.1
*We encourage you to contact us to confirm the CPT code as there may be variations depending on your particular circumstance.
- Gap Exception: In the instance when lactation services are NOT covered by anyone IN your insurance network in the area in which you live, you can apply for what’s called a gap exception which basically means that in the absence of in network providers you would request a special agreement with your insurance and myself in which they would agree to cover or reimburse the visit given the special circumstances. In this case, you can call your insurance company and provide them with the same provider information as detailed above.
Note: Any time you call your insurance company, make sure to obtain a reference number and note that down as well as the name of the representative you spoke to.