Insurance Reimbursement Appeal Letter Sample

photoThis letter is my formal appeal of the rejection of Claim Number ____ for Lactation Consultation Services provided for my son, (name) on (date) for the amount of  ______.

Summary of Events: Child was born on (Date). He was discharged from the hospital on (Date) (Detail here whatever complications you had with feeding/jaundice/dehydration/re-admittance to hospital, etc) On (Date) we met with our pediatrician, (Name) and expressed concerns about breastfeeding. Dr. _______ noted that baby was struggling to thrive and referred us to Lactation Consultant, Renee Beebe, M.Ed., IBCLC. Renee provided her services on (Date). Following the consultation, I submitted all required paperwork to (name of insurance company) for reimbursement. On (Date), I received an Explanation of Benefits (referenced above), noting the claim was denied. Continue reading

My Baby Has Reflux!

Baby with tight frenulum.  No tongue elevation present.“My pediatrician says my baby has reflux! She says there are medications to help. I really don’t want my baby to take medicine. He’s so little. But I also don’t want him to suffer and spit up so much. What should I do? Can you help me?”

Although the diagnosis of reflux seems ominous, keep in mind that all babies have reflux to some degree. The sphincter muscle that separates the stomach and the esophagus is loose and lets fluids go back and forth. That’s why it’s common for babies to spit up after a meal. If your baby seems uncomfortable, however, he may need some help.

I see many babies diagnosed with reflux in my practice. I have found that some simple changes in feeding posture or management can decrease symptoms substantially. Most of my clients do not need to medicate their babies. Continue reading

A Perfect Latch

Perfect Latch in Football Hold

Here is a beautiful example of a football hold latch. This baby is just 5 days old, but he knows exactly what to do! (Yes his skin is a little yellow, but he’s vigorous, gaining well and his pediatrician is not concerned.)

How do we know this latch is perfect?

His nose is tilted away from mom’s breast.

His chin is tucked in firmly to the underside of the breast. Continue reading

Claire’s Breastfeeding Story

 

Baby and mom breastfeeding with IGT

Claire contacted me when her baby was 5 weeks old. Her first week of breastfeeding resulted in cracked, bleeding nipples and a bacterial infection. Her nipples were so sore, she had to stop breastfeeding. She did, however, pump regularly to preserve her milk supply. Breastfeeding was important to Claire. She had fond memories of nursing her first daughter. She desperately wanted to nurse this new baby as well; but was afraid to try again.

Claire told me her story and asked for help to breastfeed her newborn daughter without pain. She was concerned that, after 4 weeks of bottle-feeding, her baby may not want to breastfeed. She was also concerned about her milk supply—she was not able to “keep up” with her baby—needing to supplement with some formula each day.
Continue reading

Cross Cradle Latch with Claire

Notice the position of the baby relative to mom’s breast.  The baby is slightly under the breast and her top lip is aligned with the nipple. Mom waits for the baby to open wide.  When latched correctly, baby’s top lip barely covers the nipple.   See “Claire’s Breastfeeding Story” for more detail about this video clip.

http://www.youtube.com/watch?v=k9YroD7JgbQ