Services - IBCLC Credentialing and Billing LLC

Credentialing & Contracting

We support International Board Certified Lactation Consultants (IBCLCs) in obtaining credentialing with commercial insurance plans across Idaho that recognize IBCLCs for independent billing.

Provider Requirements

To begin the credentialing process, providers must have:

National Provider Identifier (NPI)
Tax Identification Number (EIN)
Active CAQH profile

What We Handle

Collecting provider information and required documents
Preparing and submitting credentialing applications to insurance payers
Managing re-credentialing requirements
Basic CAQH maintenance to ensure accuracy and completeness
Tracking and monitoring application progress through completion
Negotiating and finalizing contracts with insurance networks
Providing basic compliance support

Claim Submission & Tracking

ERA/EOB reconciliation
Denial management
Preventive lactation billing expertise

Compliance & Practice Support

Documentation requirement guidance
Record retention best practices
Non-covered service form template guidance (within scope)

Services Outside Our Scope

This section is designed to safeguard you by making sure you have a clear understanding of the services we provide. It safeguards our work by keeping everything compliant and within appropriate professional limits. And it safeguards our working relationship by establishing clear expectations from the outset as we serve as a third-party credentialing and billing support provider for International Board Certified Lactation Consultants (IBCLCs) in Idaho.

No clinical care, medical advice, diagnoses, treatment, or patient communication
No legal, tax, accounting, or compliance representation
No guarantees of network acceptance, reimbursement, or insurance outcomes
No practice management, scheduling, staffing, or business operations
No tech support, EMR/EHR systems, equipment, or marketing services
No HR functions, payroll, benefits, or employment decisions
No services for non-IBCLC provider types
No claim submission without provider approval; no altering documentation
No guarantees regarding timelines, payments, or regulatory compliance