South Bay Baby Care Nursing Services, INC
by Lisa Grossman, RN, IBCLC
Insurance Information for Prenatal & Postnatal Lactation & Infant Feeding Consultations
Insurance
South Bay Baby Care utilizes The Lactation Network (TLN) & Wildflower to provide insurance-covered pre/postnatal lactation & infant feeding services.
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Payment options and insurance:
PPO insurance or UHC HMO - please use the following link to check insurance eligibility for pre-approval:
https://go.lactationnetwork.com/SouthBayBabyCareNursingServices
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Cigna insurance - please use the following link to check insurance eligibility for pre-approval:
https://portal.wildflowerhealth.net/affiliate-care/515cf77
Please read on for additional information.
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PPO Insurance + United HealthCare (UHC) HMO with pre-approval from The Lactation Network (TLN)
South Bay Baby Care utilizes The Lactation Network (TLN) to provide insurance-covered lactation & infant feeding services. If you have UHC HMO or PPO insurance through one of the following insurance carriers you may qualify for a minimum of 6 insurance-covered In-home and/or Telehealth Lactation Consultations!
PPO insurance carriers: Blue Cross Blue Shield, Anthem, United HealthCare (UHC), Humana, Provider Network of America (PNOA) and MultiPlan (MultiPlan contracts with multiple PPO providers such as Aetna, Blue Shield and more). Look for the MultiPlan logo on your insurance card to determine if you may be eligible.
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To determine if your insurance qualifies, please use this link or scan the QR code (desktop only):
https://go.lactationnetwork.com/SouthBayBabyCareNursingServices
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Once pre-approved your appointment may be scheduled.
If your insurance is denied you have the option to schedule your appointment as a self-pay patient (see below).
Initial consultations are 75 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 lactation@southbaybabycare.com for more information related to services.
Any questions related to insurance should be addressed with TLN at care@tln.care.
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Cigna Insurance
South Bay Baby Care utilizes Wildflower to provide insurance-covered lactation & infant feeding services for patients with Cigna insurance.
If you have Cigna insurance you may qualify for 6 insurance-covered In-home and/or Telehealth Lactation Consultations!
To determine if your Cigna policy qualifies, please use this link or scan the QR code (desktop only):
https://portal.wildflowerhealth.net/affiliate-care/515cf77
Once pre-approved your appointment may be scheduled.
If your insurance is denied you have the option to schedule your appointment as a self-pay patient (see below).
Cigna consultations are 60 minutes in duration. Any follow-up concerns can be addressed via a follow-up in home and/or telehealth consultation.
A travel fee will apply for in-home consultations to cover travel time and costs that are not covered by insurance.
Please contact lactation@southbaybabycare.com for more information related to services.
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Self-pay + Superbill
I offer self-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 newborn care and breastfeeding, lactation and infant feeding visits.
Upon request, I will supply a superbill once your services have been paid in full. The superbill can be submitted to your insurance, HSA or FSA to request reimbursement. South Bay Baby Care is out-of-network with all insurance providers. I cannot guarantee insurance, HSA or FSA reimbursement. If your insurance company, HSA or FSA denies payment I am happy to update codes as needed and/or provide an appeal letter to be submitted. Service fees are due at the time that services are rendered for cash-pay patients. A travel fee may apply depending upon where you are located and mileage/commute time.
Initial consultations for self-pay patients are 60, 90 or 120 minutes in duration and include a specified follow-up communication period via secure email messaging.
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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:
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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
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Billing for Before Baby Consultations
Insurance coverage for 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. Payment in full is due at the time that services are rendered. Some insurance 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.
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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 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.
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For urgent requests: Please email lisa@southbaybabycare.com and write "URGENT" in the subject line.
Please include the information requested below.
(Please note that I am offline while with patients & I will respond within 24 hours in most cases).
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To schedule a Lactation Consultation or After Baby session, please email lisa@southbaybabycare.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
3) Concern(s)
4) Location (please include city and major cross streets)
5) Availability & urgency (*please make a note in the subject line if your request is urgent)
6) If you were referred by a Pediatrician, Doctor, Dentist, Pelvic Floor PT, Bodyworker, or other medical professional
7) Any additional pertinent information
