Lactation Visit Receipt (LVR)
Lactation Visit Receipt (LVR)
"a lactation superbill" and more lactation forms
 Creating
Professional
Excellence
for the
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 Revised June 2006
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.
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.
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A major revision of the Lactation Visit Receipt Packet was completed on June 10, 2006. It can be Ordered On-line or order by
Mail In Order Form
(PDF).
The complete packet is now available on CD-R or it can be attached e-mailed in a zip file. 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).
If you have questions,
 E-mail at PatIBCLC@aol.com________________________________________________
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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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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Order Form for Mail or Fax Orders
SAMPLE
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Three Ways to Order the LVRSTEP 1)
Please email the information necessary for the customized header of your Lactation Visit Receipt (SUPERBILL)
to PatIBCLCPayPal@aol.com All the information in the example below is necessary to fill your order.
Lactation Services
Pat Lindsey, IBCLC
Registered Board Certified Lactation Consultant
P.O. Box 9999, Anytown, FL 09999 - Phone 1-888-900-0000
* NPI # 1234909876 Tax ID # 59-999999
STEP 2)
Pay for your order.
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* PLEASE NOTE:
Regarding these numbers: Insurance companies want them on any claims that are filed. 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.
BEFORE ordering the LRV, you should obtain an Employee ID Number (EIN) if you do not already have one (sometimes referred to as a Federal ID Number). Healthcare insurance plans require EINs to process claims. You may apply online.
 NEW REQUIREMENT FOR Healthcare providers to have a National Provider Identifier by MAY 23, 2007.
NPI Informational Flyer
PDF I am now recommending superbill have both an
EIN and a NPI number on it.
You may find out more and apply for NPI at
Taxonomy codes when applying for NPI are:
163WL0100X (for RN, IBCLC)
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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| 5 MUST for Every Private Practice IBCLC |
# 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 |
# 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.