RICHMOND, Va. β Anthem Blue Cross and Blue Shield will allow more lactation providers in Virginia to join their network after CBS 6βs Melissa Hipolit brought the insurer coverage concerns raised by families and lactation consultants in Richmond.
Kelsey Carroll, co-owner of Coming Home, which provides in-home lactation services, learned this summer that her clients with Anthem BCBS insurance could no longer use their coverage for her services.
"Half of the clients we see here in Richmond are Anthem and Blue Cross covered," Carroll said.
The problem began in July when the third-party company that processed insurance claims for Coming Home, The Lactation Network, sent an email stating it had not been successful in securing contracts with many Blue Cross Blue Shield plans they previously billed.
This change had immediate impacts on mothers like Rebecca Saur, who needed lactation support for her son Theo.
"Having to stop seeing Kelsey before I got the hang of pumping really impacted my supply, and it impacted my ability to continue breastfeeding him," Saur said.
Saur had initially sought Carroll's help when her son needed to have his tongue tie reversed at two months, which meant he had to relearn how to breastfeed.
"She helped him relearn how to latch post revision," Saur explained.
Carroll tried to register directly with Anthem to become an in-network provider but encountered roadblocks.
"There is no option to go in network with them as lactation," Carroll said.
Determined to bring about change, Carroll started a petition to pressure Anthem to cover services from International Board Certified Lactation Consultants like her.
CBS 6βs Melissa Hipolit saw the petition and reached out to Anthem BCBS to learn more about why Carroll and other International Board Certified Lactation Consultants seemingly could not get in network with the insurer.
Within hours, someone from Anthem called Carroll and told her they changed their website to allow lactation consultants to be able to go in network wtih them.
"I think I'm still a little stunned," Carroll said. "I'm so grateful. I'm so glad you reached out. Truthfully, without you I don't think it would have gone anywhere."
Carroll emphasized that breastfeeding support is recommended by major health organizations.
"The AAP, the World Health Organization, the CDC, they all recommend breast milk until 6 months exclusively or longer, a year, two years," Carroll said.
The change is welcome news to Saur, who hopes to use Carroll's services again in the future.
"When we have more children, I think it's going to be really helpful to be able to reach back out to Kelsey," Saur said.
A spokesperson for Anthem provided this statement:
"Anthem is dedicated to supporting the health of moms and babies by covering a wide range of lactation services, reimbursed through our standard claims process. To expand access and better serve families, Anthem has recently enhanced its enrollment process in Virginia, allowing more lactation providers to join our network."
CBS 6 is committed to sharing community voices on this important topic. Email your thoughts to the CBS 6 Newsroom.
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