We are a medical breastfeeding practice, not a lactation practice. Even though you may be seen in our office by a lactation consultant, you will also be seen by a physician who is a board-certified lactation consultant and a specialist in breastfeeding medicine. Your visit will be billed as a physician office visit for both the mother and the baby (two separate visits in most cases).

Every insurance company and plan is different. Some will consider us specialists and you will need whatever referrals or authorization you need to see a specialist (for both the mother and the baby). Consults may require a referral from the mother’s obstetrician, midwife or PCP, and from your baby’s pediatrician (unless the baby is a patient at Covenant Care Pediatrics). Restrictive HMO plans would be most likely to require you to have a referral. Most plans will just consider us as another doctor for you and your baby. You are responsible for checking with your insurance company to find out about your plan’s requirements.

If you call your insurance company, do NOT ask if they cover lactation services or lactation consultants. We are a medical practice and you need to ask about seeing a medical specialist. Seeing a specialist is covered; many insurance companies do not cover “lactation services.”

We will bill your insurance company for both you and your baby. Your insurance plan may have deductibles, co-insurance, or other out-of-pocket expenses for you and/or your baby. If your insurance company says that part of the visit is uncovered or is your responsibility, then you will be responsible for these charges. These charges typically include co-pays, co-insurance, and amounts applied to your deductible.

It is impossible for us to predict in advance what your out-of-pocket costs might be. Also note that you must add your baby to your insurance plan or visits to our office (and to your baby’s doctor) may not be covered. We will work with patients who are experiencing financial hardships.

Two patients

Breastfeeding obviously takes two, and diagnosing and treating problems usually requires treating both the mother and the child, with history, exam, diagnosis and plan for both patients as well as observing a breastfeeding session. Since consults involve treating two patients, we will bill for both mother and baby.

If your insurance company requires a referral, you will need one for you from your OB/GYN or primary care doctor, and one from the baby’s doctor (unless a patient at Covenant Care Pediatrics).

If your insurance company requires a specialist or primary care co-pay, then two will be needed, one for you and one for the baby. Most insurance companies do not classify us as specialists, but sometimes they do require a specialist co-pay amount.

Insurance plans

We accept most insurance plans. If you want to check to see if we are in network, check under Dr. Patrick Pulliam or Covenant Care Pediatrics. Be sure not to ask if lactation services/consults are covered; ask about seeing a specialist for you and for your baby.

We currently accept the following insurance plans:

  • Aetna HMO & PPO
  • Amerigroup Georgia Medicaid & PeachCare for Kids managed care
  • Beech Street PPO
  • BlueCross/BlueShield of Georgia (all plans, including Blue Choice HMO/POS, Open Access, Direct Access, and PPO)
  • Cigna HMO & PPO
  • Coventry HMO & PPO
  • First (1st) Medical Network PPO
  • Georgia Medicaid and PeachCare for Kids, including Amerigroup, WellCare & Peach State managed care plans
  • Humana (all plans, including HMO & PPO)
  • Humana Military (TRICARE)
  • Kaiser Multichoice (Multiplan) PPO
  • LifeWell Health Plans
  • Medi-Share
  • Multiplan PPO
  • NovaNet PPO
  • PeachCare for Kids
  • Peach State Georgia Medicaid & PeachCare for Kids managed care
  • PHCS PPO
  • Piedmont WellStar/ Piedmont 360
  • State Health Benefit Plan
  • Tricare (Humana Military)
  • United Healthcare (all plans)
  • WellCare Georgia Medicaid & PeachCare for Kids managed care

If you do not see your plan listed here, please call our office.