how NUTRITION COUNSELING works

CHOOSE FROM TWO OPTIONS:

BOOKING WITH INSURANCE VS. SELF-PAY FOR NUTRITION SESSIONS

WILL INSURANCE COVER MY APPOINTMENT?

We are in network with Aetna, Amerihealth, Blue Cross and Blue Shield plans including Anthem and Horizon, Independent Blue Cross, and Cigna.

We are considered OUT OF NETWORK with any other provider. If you would like to use an out of network insurance provider, you would pay our self-pay rates at the time of service and we can provide a Superbill document that you can submit to your provider for reimbursement.

QUESTIONS FOR INSURANCE COMPANY

If the insurance company asks for a procedure code (CPT code) please provide them with the following codes 97802 for the initial session & 97803 for follow up sessions.

If they say you do not have coverage using those codes NEXT ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404.

WILL MY DIAGNOSIS BE COVERED?

If the representative asks for a diagnosis code – please tell them the visit is coded the ICD 10 code: Z71.3 OR Z72.4. We always try to code your visit using preventative coding to reduce deductible and copay costs and maximize the number of visits you receive from your insurance carrier.

HOW MANY VISITS DO I HAVE PER CALENDAR YEAR?

Your carrier will let you know how many visits they are willing to cover. Depending on the carrier the number of visits varies from 0 to unlimited depending on medical needs.

HAVE I MET MY DEDUCTIBLE?

In the event that you have a deductible AND you are an out of network carrier, I will not be able to initially bill your insurance company directly. Therefore, payment of $175.00 is due at the initial 60 minute Telehealth session and $135.00 is due at each follow-up Telehealth session.

We will provide you with the appropriate documentation to submit to your insurance company to show receipt of the services. This will allow you to “pay down” your deductible. Once your deductible has been met and you have nutrition services on your policy, I can then directly bill your insurance company.

DO I HAVE A CO-PAY FOR NUTRITIONAL COUNSELING?

For most insurance companies we are considered specialists. Therefore, your specialist co-pay is applicable and is payable at the time of service. This information is often apparent on the front of your actual insurance card.

DO I NEED A REFERRAL?

Be sure to ask your insurance company if a referral is required in order to see a Dietitian. If required, you can request a referral or letter from your primary doctor and then upload it into your Simple Practice client portal. We must have the referral BEFORE the appointment in order for your visit to be covered.

Be sure to ALWAYS get a reference code from any representative you speak with at your insurance company. This helps to keep the insurance company accountable for any information they provide you with on your call.

In light of COVID-19, many insurance companies are waiving all member cost-shares. So please be sure to specify that this will be a TELEHEALTH appointment so that you have the correct information.

FOR INSURANCE

I am in network with Aetna, Amerihealh, Blue Cross and Blue Shield plans including Anthem, Horizon and Independence Blue Cross, and Cigna.

Before you schedule an appointment with practical and individualized performance nutrition and guidance, let's first answer one of the most common questions - "Will my insurance pay for my nutrition counseling session with a Registered Dietitian?"

Even though I am in network, you will still need to call your insurance before scheduling an appointment with the following script attached below. I've created this form to clarify nutrition coverage, help avoid claim denials and provide the most comprehensive care for my patients.

Start by calling the 800 number on the back of your insurance card and ask to speak with a representative using the attached document to see if and how many nutrition telehealth visits are covered along with additional information on the attached form. If you have other insurance, the form provides some questions for Out of Network benefits.

Then kindly scan or take a photo of the form and email it back to me after completing the call and then you're ready to book! You can then book a session directly on my website and select the first option, Medical nutrition therapy; initial assessment & intervention, individual, face-to-face with the patient, each 15 minutes for 1 hour total.

You can then add all of your demographic and insurance information here.

Nutrition Application

Insurance Verification Form

ificat

FOR SELF-PAY

For other insurance carries outside of Aetna, Amerihealth, Blue Cross and Blue Shield plans Horizon and Anthem, Independent Blue Cross, and Cigna, you can inquire with the ABS Verification of Benefits Form pdf in the FOR INSURANCE section above and you will need to pay for the visit at the time of service using my packages and submit a superbill for possible out of network reimbursement.

I offer several self-pay discount packages to best meet your nutrition and fitness needs. After choosing your package, you can book a session directly on my website and choose the appropriate box for your package.

SELF-PAY DISCOUNT PACKAGES PDF

Evidence-based treatment with compassionate care

Explore our options for nutrition counseling, sports performance, personal training, yoga and fitness classes, or all of the above! All sessions are conducted through HIPPA compliant telehealth platform and are tailored to your specific needs.

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