Insured with Aetna?
North Shore Lactation is an in-network provider with most Aetna plans. Most Aetna plans cover up to six visits at 100% coverage. Sometimes after visit 3, Aetna may assign a co-pay or deductible which the patient will be responsible for. You may consider calling Aetna to confirm. If you have Aetna Better Health or Aetna through University of Chicago, see below.
Click here to book your consultation.
Insured with Aetna Better Health of Illinois (Medicaid) or Aetna through University of Chicago Illinois?
For Aetna Better Health: A preauthorization is necessary for your services to be covered if you have Aetna Better Health. Please have your OB/Midwife complete this form with the below information and have it faxed PRIOR to your appointment date. Failure to do so will result in your visit(s) not being covered by insurance and you will be invoiced the self-pay rate. For the form, please ensure that your provider selects outpatient and includes the following information:
Diagnosis Codes: z39.1
CPT Codes: 99345, 99349, S9443, 99204, 99214, 99354
Servicing Provider: Melissa Block/North Shore Lactation
Tax ID: 35-25-86999
NPI number: 1851838858
Phone Number: (847) 220-4192
Fax Number: (844) 294-9180
Specialty: Lactation Consultant, IBCLC
Number of visits: request 6
Using the Aetna appointment links above, please book an appointment. Ensure that the date on the prior authorization is ON or BEFORE your appointment date.
For Aetna through University of Chicago: A Network Deficiency Approval is required. Please call Aetna to obtain a Network Deficiency Approval prior to booking.
Insured with United?
North Shore Lactation is an in-network provider with United (except Advocate Health plans - contact North Shore Lactation to discuss). Use the link below to book your initial appointment
Click here to book your consultation.
Insured with BCBS PPO, Cigna PPO or Anthem PPO?
Through a partnership with The Lactation Network, those with BCBS PPO, Cigna PPO and Anthem PPO insurance are typically covered for unlimited visits at 100% coverage. To confirm your coverage, please complete this form (https://go.lactationnetwork.com/NorthShoreLactation). The Lactation Network will then email you to confirm your coverage. Once you are approved, use the link below to book your appointment.
Click here to book your consultation after you are approved by Lactation Network (see form above).
Insured with Tricare?
North Shore Lactation is an in-network provider Tricare. You may consider calling Tricare to confirm.
Click here to book your consultation.
Insured with North Shore 447 or 243 HMO?
North Shore Lactation is an in-network provider North Shore 447 HMO. Please proceed to booking.
Click here to book your consultation.
Insured with a different provider (MeridianHealth, Medicaid or HMO)?
Payment is requested at the time of booking. North Shore Lactation, LLC will provide you with a Super Bill receipt so that you can submit a claim to your insurance company. The Affordable Care Act mandates coverage for lactation support. If you have non-grandfathered health insurance, your visit should be reimbursed at 100%!
To increase your chances of reimbursement, you might consider calling your insurance company before your consultation to request a geographical exception, also known as GAP coverage. They will want to know that we will typically bill with codes S9443, 99345 and 99204. It is your responsibility to advise us on which codes your policy covers.
For HMOs, North Shore Lactation recommends that you seek a referral from your provider dated prior to or on the date of anticipated service. Reimbursement is unlikely for HMOs without your provider referral sent directly to your insurance company.
As part of women’s preventive services, new plans are required to cover breastfeeding support, supplies, and counseling. Check out this toolkit for more information. The health care law requires all new health plans to cover “comprehensive prenatal and postnatal lactation support and counseling.” This means that breastfeeding mothers have health insurance coverage for lactation counseling without cost-sharing for as long as they are breastfeeding.
Business Information
Tax ID: 35-25-86999
NPI number: 1851838858
Phone Number: (847) 220-4192
Fax Number: (844) 294-9180