Access MOM (Mother's Own Milk)
Report a Dispensed Pump
After BFA billing confirms coverage, dispense the pump and record it here.
First
Complete the paper Breast Pump Dispensed form attached to the pump box, and dispense the pump to the patient. Then report it below.
Opens IntakeQ in a new tab
Important
Use the exact same patient name and phone number you entered when you verified insurance. The fields are sensitive to extra spaces, and matching them is what links this report to the verification.
Here are the steps in detail
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Open the form.
- Use the button above. The form opens in a new tab.
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First page of the form.
- Enter the Patient's Legal Full Name, exactly as entered at verification
- Enter the Patient's Phone Number, exactly as entered at verification
- Tap Continue
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Fill out each section.
- Provider contact information: Your Name, Your Facility, and Your Best Contact Method
- Provider contact, part II: Your Phone, Email, or Fax
- Purpose of the form: select Report pump dispensed
- Upload the completed form: tap Select file(s) to upload, choose Take Photo or Video, and photograph the completed paper Breast Pump Dispensed form
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Submit.
- Tap Submit Form at the bottom.
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Done.
- That completes the report for this pump.
Questions about a dispense? Call BFA billing at (404) 454-9715.
Our Goal
Access MOM (Mother's Own Milk) helps more newborns receive human milk, especially premature and low birth weight babies, by making sure families get the breast pump their Medicaid or insurance already covers, delivered soon after birth, when early and frequent milk expression matters most for establishing supply. The American Academy of Pediatrics identifies a mother's own milk as the optimal nutrition for very low birth weight infants and points to local breast pump access programs as a way to reduce inequities in who receives it. National experts likewise call for guaranteeing equal access to covered breastfeeding supplies and equipment, which is what this program puts into practice.
Informed by national pediatric and public health guidance: Parker MG, Stellwagen L, Miller ER, et al. Promoting Human Milk and Breastfeeding for the Very Low Birth Weight Infant: Clinical Report. Pediatrics. 2026;157(2):e2025073625. Meek JY, Noble L; Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. 2022;150(1):e2022057988. National Academies of Sciences, Engineering, and Medicine. Breastfeeding in the United States: Strategies to Support Families and Achieve National Goals. Washington, DC: The National Academies Press; 2025.