Insurance Reimbursement

As an Advanced Practice Nurse (APN) practicing in the state of Illinois with this license, and specializing in lactation as an International Board Certified Lactation Consultant (IBCLC), I am a provider for Blue Cross/Blue Shield PPO. This means that I will take your policy information and submit your claim for you. In the state of Illinois, HMOs do not cover APNs. Therefore, if you have a HMO, payment will be expected at the time of your appointment. Other PPO type of insurances may cover partially, but you will be given the billing form to submit to your insurance. Payment for the appointment is expected at the time of the visit. Payments can be in the form of cash, check, Visa, or Mastercard. Flex-spending cards can be used. Those patients with Blue Cross/Blue Shield PPO will provide a credit card form to be used for any deductibles or copays once the EOB arrives (see Intake Form and Credit Card Form on Home Page.) Do not call Blue Cross/Blue Shield and ask the question, “Do you cover lactation consultants?” They will say no because they don’t cover them. However, if you seek accurate information on my status as a provider, ask them to look up my name “Carol Chamblin," or ask them if your policy covers seeing a “nurse practitioner” as in the Advanced Practice Nurse license. In the state of Illinois, APNs have licenses to practice within their scope of care. These are the clinics that have sprung up rapidly in the area, such as CVS, Walgreens, etc. APNs staff them, and APNs also practice in private practice, hospitals, and other doctor offices. 

Sincerely,
Carol Chamblin, RN, APN, IBCLC