Insurance

Health Insurance

Health insurance can be stressful when you are looking for a lactation consultant. Ashley is in-network with some insurance companies. See in-network, out-of-network, Aetna, and employer program information below

In-Network

Ashley is in-network with Aetna and United Health Care of Connecticut and New York. 

As an in-network provider, Ashley will verify your insurance coverage. She will bill your health insurance directly. 

With any medical visit, once the claim is processed, there is the possibility of owing a copayment, coinsurance or part of your deductible. *If you have Aetna Insurance, scroll down and read*

Aetna Insurance

As of September 1, 2024, Aetna has made policy and reimbursement changes for lactation consultants. I’m going to do my best here to explain these changes: 

When you call Aetna, they will explain that you have 6 “free” lactation visits, but what they do not explain is what those “free” lactation visit codes cover. S9443 is the lactation class code that is covered by these 6 “free” visits. There are only 2 visits that Ashley Robinson offers that are covered by this one code” 30-minute virtual prenatal visit and 30-minute virtual follow-up visit for existing patients. 

For in-person lactation consultation, there is a more comprehensive aspect needed in order to give you and. your family the best lactation care. Again, due to Aetna’s new policy changes, they have removed all other codes that we are able to use to be paid a fair wage. You need to know that Aetna has forced our hand and yours in passing some of the fees for timed codes off on you, the patient. These fees will range based upon your insurance plan and we will do our best to give you an estimate of what these fees may be. 

If you choose to schedule a visit with Ashley Robinson, there will be a separate consent form that will provide you with more details regarding these new billing practices. You are also welcome to email Ashley with any questions. [email protected]

Out-of-Network

All other insurance carriers are considered out-of-network. In this case, families wanting to schedule a lactation consult with Ashley are encouraged to call their insurance company and ask about out-of-network lactation coverage. Families should have access to gap exceptions and reimbursement. When calling insurance companies, families may need the following information:

  • Provider: Ashley Robinson
  • NPI: 1255927620
  • TIN: 862028428
  • Dx Code: Z39.1
  • CPT Code: S9443
  • POS Code: 12 

Employer Programs

Ashley is also a certified labor doula and is certified through employer programs like Maven or Carrot. If you have these benefits, mention them to Ashley when scheduling your appointment.