The Fourth Trimester is the term for the transition period after childbirth, this period comes with unique challenges and needs.

A Fourth Trimester Clinic focuses on providing comprehensive care and support to mothers and their newborns during the first several months after childbirth. At The Knapp Clinic, we offer specialized services to address the physical, emotional, and psychological needs of new mothers/parents and their infants. Our services include lactation consulting, perinatal mental health support, and guidance on newborn care and bottle feeding. Our team of experienced healthcare professionals is dedicated to ensuring a smooth transition into this new phase of life, by promoting both maternal/parental and infant well-being during this crucial period.

We provide lactation services and have IBCLCs on staff. Because The Knapp Clinic is a medical clinic we provide many services and types of care including lactation care by Internationally Board Certified Lactation Consultants.

The Knapp Clinic participates in the Center Care Provider Network to include the following plans: Kentucky Medicaid plans including: Wellcare, Humana, Anthem Blue Cross Blue Shield, Aetna Better Health, Passport by Molina, and United Healthcare Community Plan. PPO Plans include: Med Center Health Gold & Silver Plans, Aetna, Cigna, Humana, United Healthcare, Anthem BCBS, City of Bowling Green, Encore Health* *This list is not all inclusive, Please contact your health insurance company for specific details on the benefits of your individual plan and for the In-Network status of our clinic provider. We accept Tricare Select and bill for out of network services. You are responsible to know your insurance coverage and benefits before your scheduled visit. Use of insurance does not guarantee full coverage of services. If your medical insurance plan has a deductible that has not yet been met, copays, or coinsurance requirements for services you will receive a bill for those amounts determined by your insurance policy. We are currently not in-network with Tricare, United Healthcare Dept of Veterans Affairs Community Care Network (UHCVA CCN), or Medicare.

If you have a deductible that has not been met, copays, or coinsurance then you will be required to pay your portion at the time services are provided. For the exact rate and to know what you might be responsible for, please call your insurer directly. ​ When we are working with both an infant and mother/ lactating parent we complete a full office visit for both infant and parent and bill accordingly. We are a medical clinic and will bill insurance on behalf of the infant and mother/lactating parent. *Please note two claims will be submitted to insurance and both claims will be subject to deductible, coinsurance, and applicable copays.*

The most commonly used billing codes and associated prices can be found here: New Patient Office Visit: 99205 - $210.00 99204 - $175.00 99203 - $145.00 99202 - $115.00 ​ Follow Up Patient Office Visit: 99215 - $170.00 99214 - $145.00 99213 - $120.00 99212 - $90.00 99211 - $60.00 ​ Frenectomy Codes 41115 - $300 (Removal of the lingual frenulum) 40819 - $300 (Removal of the labial or buccal/cheek frenulum) Common ICD 10 Diagnosis Codes Used: Encounter for care and examination of lactating mother - Z39.1 Ankyloglossia (tongue tie) - Q38.1 Congenital malformations of lips, not elsewhere classified (lip/cheek tie) - Q38.0 Difficulty Feeding - P92.5 ​ Example of a typical claim* submitted to insurance for lactation support and evaluation: ​ Mother/Lactating Parent evaluation and lactation support: 99205 Infant Evaluation: 99204 ​ Follow up lactation support for Lactating Parent/Mother: 99215 Follow up infant: 99215 *This is an example and not a guarantee of what will be billed out or submitted. All claims/bills submitted to your insurer are based on medical complexity and time. The Knapp Clinic NPI: 1356069751 Jacqueline Cropper NPI: 1194360446 ​

Tongue tie, or ankyloglossia, is a condition where the mucosa under the baby's tongue (lingual frenulum) is shorter than normal, restricting the tongue's movement. This can impact feeding by making it difficult for the baby to latch properly and effectively remove milk from the breast or a bottle.

Lip tie, or labial frenulum, is a condition where the thin piece of skin between the upper lip and the gum is tight or thick, potentially restricting the lip's movement. This can impact feeding by causing challenges in achieving a proper latch and affecting milk transfer from the breast or bottle.

Infants over 5 months old or over 16 lbs will be evaluated for in office frenectomy on a case by case basis. Older babies and toddlers will be referred out to practitioners with expertise in these age groups if a frenectomy procedure is needed. The Knapp Clinic will continue to assist with care before and after the procedure for older babies.

We use a CO2 laser for frenectomy procedures due to its precision and ability to minimize bleeding and discomfort. The laser allows for more controlled tissue removal, reducing the risk of complications and promoting faster healing compared to scalpel or scissors.

Wound care, which is sometimes referred to as "exercises" or "stretches" after a frenectomy is crucial to prevent reattachment of the lased area and promote full range of motion healing. Active wound care helps maintain the newly created space, prevents excess or tight scar tissue formation, and improves the range of motion in the affected area.

At The Knapp Clinic, we prioritize the comfort and care of our patients during frenectomy procedures. We utilize various techniques for pain control, including warm swaddles, and topical numbing, which is applied to the sites to ensure minimal discomfort during the procedure. Additionally, we may recommend over-the-counter pain medication or homeopathic remedies for managing discomfort after the procedure. Our team is dedicated to providing a supportive and comfortable experience for every patient undergoing a frenectomy at our clinic.

Our fee for frenectomy and the CPT codes we bill your insurance are: Frenectomy Codes 41115 - $300 (Removal of the lingual frenulum) - Tongue Tie 40819 - $300 (Removal of the labial or buccal/cheek frenulum) - Lip Tie How much you owe after we bill your insurance will be based on your insurance plan's deductible, co-insurance, and co-pays. For more information about exact pricing please contact your health insurance plan.