Lactation Visit Receipt (LVR)
"a lactation superbill" and more lactation forms
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Effective October 1, 2009 - The most widely used Diagnoise IC-D 9 code changed from 779.3 to 779.31 (feeding difficulties in newborn 28 day old or under).
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Creating
Professional
Excellence
for the
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Revised Fall of 2009
Complete Packet is
Now Available on CD
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The Lactation Visit Receipt Packet
The LVR Packet is INTENDED for use by IBCLCs, doctors, nurse practitioners or other health care providers
with at least IBCLC designation or greater.
If verification cannot be made of Board Certification through IBLCE or higher designation,
do NOT order, the order will not be filled.
International Board Certified Lactation Consultant ( IBCLC ) is the Gold Standard in lactation consulting.
A note from Pat: I began my research into 3rd Party Reimbursement to design a superbill to meet my practice needs, I did a survey of about 30 LCs (most in private practice) to see what they thought was important in a lactation superbill. While doing the survey, there was so much interest in a new superbill with up-to-date coding that I was urged to make it available to others. This resulted in the Lactation Visit Receipt Packet. The LVR Packet has been reviewed by many of my peers and can be found in Linda Smith's book “The Lactation Consultant in Private Practice: The ABCs of Getting Started”, in Breastfeeding and Human Lactation, 3rd Edition, Jan Riordan, in ILCA's "Reimbursement Tool Kit" by Marsha Walker and in Medela's Messenger issue 20.1, 2003.
Use of the LVR does not guarantee reimbursement. This tool is used as a professional receipt for lactation service which is given to the consumer to file for
insurance reimbursement, however, insurance reimbursement should never be guaranteed unless the provider has a contractual agreement with the
consumer's insurance company and lactation are coved benefits on the consumer's insurance policy. The actual Lactation Visit Receipt is in a pdf so as many or as few copies as needed can be printed. You may want to print it out and take it to a printer such as Office Depot, Office Max or Staples for printing. The LVR is
recommended to be printed in triplicate.....office copy, client copy and copy to be filed with insurance company (in my practice I keep original copy and
give client two copies so client can file for insurance reimbursement if they wish).
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The complete packet is now available on CD-R or it can be attached e-mailed in a zip file.
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The LVR Packet includes the following:
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Customized Header on the 2006 version of Lactation Visit Receipt (Superbill) in PDF
A 18 page instruction booklet with details on filling out the LVR & basic reimbursement information in PDF
BONUS FORMS - Templates of the following in WORD:
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Breastfeeding Questionnaire / Medical History Form
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Consent / Financial Form
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Pump Rental Contract Form
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Documentation Forms
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HIPAA Privacy Practices Form
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HIPAA Compliant FAX Form
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Referral for Lactation Visit Form
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Telephone Triage Form
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AND, more
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Endorsements of LVR.....
At ILCA 2002 Conference, Marsha Walker called the LVR Packet, a "fabulous reimbursement packet."
Voted in the top 5 Best Business Investments by 2003 Private Practice Lactation Consultant Conference
"Pat Lindsey's superbill is excellent !!!! ( thank you Pat ) and It is working. I am working part-time for a Family Practice doctor who does OB. I use Pat's superbill and fax it to this docs biller. It does take me 1-2 months to get payment, however. Pat's superbill has been one of my best investments as a professional Lactation Consultant." Star Siegfried,RN,BA,IBCLC 1 June 2002
"thank you so much for the superbill and forms. They are gold. : )" Diana West, IBCLC
Copies of LVR can be found in the following books:
ILCA's Reimbursement Tool Kit for Lactation Consultants by Marsha Walker
Breastfeeding and Human Lactation, Third Edition, page 54, by Jan Riordan
The Lactation Consultant in Private Practice: the ABC's of Getting Started, page 326, by Linda Smith
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Three Options to Order the LVR
The LVR Packet is INTENDED for use by IBCLCs, doctors, nurse practitioners or other health care providers
with at least IBCLC designation or greater.
If verification cannot be made of Board Certification through IBLCE
or higher designation, do NOT order, the order will not be filled.
STEP 1) Read to the right before ordering! 
STEP 2)
Please email PatIBCLCPayPal@aol.com the information for the customized header of your Lactation Visit Receipt (SUPERBILL)
Example of information necessary to fill your order is below:
Lactation Services
Pat Lindsey, IBCLC - *Reg. 196-13391
Registered Board Certified Lactation Consultant
P.O. Box 9999, Anytown, FL 09999 - Phone 1-888-900-0000
* NPI # 1234909876 EIN # 59-999999
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STEP 3)
Pay for your order. Remember to email header information as requested in STEP 1 & 2
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* PLEASE NOTE:
I am now recommending the lactation visit receipt (superbill) to have an EIN, a NPI and the IBLCE-IBCLC registration number (if you are IBCLC).
In order to provide clients with a professional receipt of lactation services, the header should include a National Provider Number (NPI) as well as an Employee ID Number (EIN). Insurance companies want these numbers on any claims before considering reimbursement. Both numbers can be applied for and obtained online without the help of an attorney or accountant. It usually only takes 1-3 days to get both.
THEREFORE BEFORE
NEW REQUIREMENT FOR Healthcare providers to have a National Provider Identifier by MAY 23, 2007.
NPI Informational Flyer
PDF
You may find out more and apply for NPI at
Taxonomy codes when applying for NPI are:
163WL0100X (for RN, IBCLC)
364S00000X Clinical Nurse Specialist
174400000X is being used for non-nurse IBCLC Specialist - An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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OPTION 1
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for institutions who need a
W-9 completed and signed for their
purchasing department.
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New Customers
Complete Lactation Visit Receipt Packet
on CD-R
$50.00
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OPTION 2
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Upgrade - Previous Customers
who have purchased an
earlier version
Complete Packet on CD-R
$35.00
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OPTION 3
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Upgrade - Previous Customers
Upgrading Lactation Visit Receipt ONLY
by E-mail
$20.00
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______________________________________________
6 MUST for Every Private Practice IBCLC
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# 1
Click on book to order
from Hale Publishing
By Linda J. Smith & 15 private practice
contributing authors
Price: $43.95 (U.S. List)
Cover: Paperback Pages: 288
Copyright: 2002
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# 2
USLCA Reimbursement Toolkit
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# 3
The Lactation Visit Receipt Packet
by Pat Lindsey, IBCLC
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# 4
Kelly Bonyata, BS, IBCLC's
Out of the 2,163 candidates for the IBLCE 2004 Exam, Kelly scored the highest grade.
When it comes to handouts, why re-invent the wheel?
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# 5
Click on book to order
from Hale Publishing
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© 2001 Pat Lindsey, IBCLC - Lactation Services all rights reserved.
This internet site provides information of a general nature.
If you have any concerns about your own health or the health of your child, you should
always consult with a physician or other healthcare professional.
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