SunShyn Credentialing & Medical Billing Group

09/07/2026

I’m glad lactation care is finally being recognized on paper — but I’m wary. The proposed 2027 CPT codes currently risk undervaluing long, complex lactation visits and could push independent IBCLCs toward staff roles instead of preserving independent practice. As a credentialing and billing partner for small medical and lactation practices, we’re watching the CMS proposal closely and advocating for valuation and language that reflect real clinical work, fair reimbursement, and clear provider status.

If you’re a provider navigating billing or credentialing for lactation services, let’s talk about protecting your practice and reimbursement as these codes evolve. Share your experience below or click to read the full analysis. 👇

Read more: https://wix.to/2CLd1G7

The lactation community has wanted dedicated CPT codes for years.So when two new lactation-specific CPT codes appeared in the proposed 2027 Medicare Physician Fee Schedule, the immediate reaction was understandably excitement.Finally, codes that actually describe lactation care.Finally, recognition....

08/31/2026

☀️ Sunshyn Credentialing is now platform-based!

Providers can now:

✨ Track every credentialing application
🔐 Upload documents securely
📋 See what’s submitted, pending, or still needed
🔄 Follow progress all in one place

Less email chasing. More transparency. Better credentialing.

☀️ Sunshyn Credentialing — now easier to track from start to finish.

08/25/2026

08/24/2026

More tools for established practices doing their own billing but occasionally needing some pointers.

08/22/2026

We’re excited to share that the Sunshyn Learning Center is up and running.

It’s built for IBCLCs and lactation practices who want practical, organized education — not another scattered folder of PDFs.

What you can do today:

• Free access — Complete 17-step practice startup guide, interactive worksheets, free resource library, and saved progress
• Individual Premium ($15/month) — Premium learning pathways, billing and coding worksheets, payer playbooks, Form & Practice Builders, and mentorship tools
• Practice Premium ($40/month) — Everything in Premium plus team logins (5 included), owner-managed access, and a practice mentorship workspace

Create a free account and start with the startup guide, or compare plans on the membership page.

→ https://learning.sunshyncredentialing.com

Questions or feedback? We’d love to hear from you — this platform will keep growing based on what practices need.

Practice Academy — a branded education space for your patients and team — is in development and will open for signups soon.

Interactive education and resource portal for independent healthcare providers — learn it, complete it, save it, track it, and put it into practice.

08/22/2026

Apparently we have entered a new era of insurance logic.

UHC says medically appropriate infant care can still be “covered” when Baby is separately evaluated or treated.

Great.

So what does the IBCLC bill?

Because UHC also says:

Baby S9443? Not reimbursed after September 1.

The E/M codes UHC itself lists under breastfeeding services? Restricted for Lactation Specialists under another reimbursement policy.

98960? That may work for education/training, but it does not replace every separately performed infant evaluation.

So we are left with this absurd result:

The service can be covered.
The patient can be covered.
The provider can perform the care.
The code can exist.
And the provider still may not have a payable billing pathway.

From a medical billing perspective, that is not a small technicality.

That is the entire problem.

And if the logic is really that two people receiving interconnected care somehow become one reimbursable unit, then uninsured people have apparently been doing this all wrong.

Just go to the appointment with someone who has insurance.

Your care can be “covered” too.

Nobody can bill for it, but apparently that’s just a detail.

Of course that sounds ridiculous.

Because two patients do not become one patient just because they are seen together.

A lactation dyad means two interconnected patients need to be assessed to solve one clinical problem.

It does not mean one member ID.

It does not mean one medical record.

It does not mean one diagnosis.

And it certainly does not mean one patient’s reimbursement should somehow absorb the care provided to another insured patient.

— if Baby’s medically appropriate care remains covered, then tell contracted IBCLCs exactly how they are supposed to bill and be reimbursed for it.

“Covered” without a payable billing pathway is not meaningful coverage.
UnitedHealthcare UnitedHealth Group
TwoPatientsTwoClaims FairReimbursement PayForTheCare

08/22/2026

FROM A MEDICAL BILLER:

DYADIC CARE DOESN’T MEAN ONE PATIENT.
IT MEANS TWO PATIENTS HAVE TO BE ASSESSED TO SOLVE ONE INTERCONNECTED CLINICAL PROBLEM.

TWO PATIENTS.
TWO RECORDS.
TWO ASSESSMENTS.
TWO PLANS OF CARE.
TWO CLAIMS.

UnitedHealthcare : “Dyad” is not a billing unit.

08/22/2026

🌻 Something exciting is coming to Sunshyn!

We’re building the Sunshyn Learning Center—an interactive environment where lactation professionals can learn, build their practices, and find the resources they need in one organized place.

The Learning Center will replace the document library currently on our website and move our free 17-Step Practice Startup Guide into a guided, interactive pathway. Instead of simply reading pages and downloading documents, providers will be able to work through each step in order, complete activities, use practical tools, and track their progress.

Planned features include:

✨ The interactive 17-Step Practice Startup Roadmap
✨ Guided learning pathways
✨ A searchable resource and document library
✨ Editable form and policy builders
✨ Premium payer and billing resources
✨ Outpatient practice workflow training
✨ Progress tracking and downloadable tools
✨ Audio training you can listen to on the go
✨ Training for billing, credentialing, EHRs, clearinghouses, and payer portals
✨ Patient-facing Practice Academies where practices can share their own educational videos, resources, and downloads with families
✨ A structured mentorship workspace modeled around published IBLCE Pathway 3 mentorship guidelines

The mentorship workspace is being designed to help mentors organize applicants, agreements, clinical-hour documentation, timesheets, reports, patient-permission forms, and supporting records in accordance with published IBLCE guidance. It will give practices a more organized way to build and document a compliant mentorship program while keeping responsibility for meeting current IBLCE requirements with the mentor and applicant.

There will still be free resources available to everyone, with optional premium memberships for individuals and practices that want expanded tools and training.

I don’t want this to be just another collection of courses and downloads. I want it to become the most practical, comprehensive, and provider-friendly learning environment available to independent lactation professionals—and I want your input while we build it.

What would make your work easier? What training, templates, interactive tools, patient resources, or practice-building support do you wish someone would create? What have other programs been missing?

Drop your ideas below—even the ambitious ones. If it would genuinely help independent providers build stronger practices, I want to hear it. 🌻

Sunshyn Learning Center—coming soon!

08/20/2026

I’ve seen this problem enough times to say it plainly: you cannot fix a parent’s exhausted lactation benefits by billing the visit under Dad’s policy — especially if Dad wasn’t even at the appointment. When I work with small lactation and medical practices, I tell them the same thing I tell clinicians one-on-one: ask to see the claim and remittance and compare it with your clinical notes. If the claim lists Dad but your documentation shows Mom as the patient (and Dad wasn’t present), that’s a red flag.

Outsourcing billing is common and fine — lack of visibility is not. If your NPI or professional services are on a claim, you deserve to know who was billed, which codes were submitted, and how the claim was adjudicated. Protect your practice and your patients by verifying claims, asking clear questions of billing partners, and listening when patients say something doesn’t add up.

If you’re a small practice or lactation provider and want a collaborative partner who helps you maintain claim visibility and proper credentialing, we specialize in that work. Let’s make sure documentation and claims tell the same story.

Read the full post for practical steps and questions to ask: https://wix.to/chEy07Z

Apparently, this needs to be said:When a mother’s Aetna lactation benefits are exhausted, you cannot simply start billing lactation visits under Dad’s name because he has benefits available.And if Dad wasn’t even at the visit, that should be an immediate red flag.This issue is especially impor...