INSURANCE & FEE POLICY
We are considered as in-network provide for Aetna, Ambetter, Cigna, BlueCross BlueShield, and United Healthcare.
We are considered out-of-network for all other insurance plans; however, many of the health insurance policies partially or fully reimburse our services. For this reason, payment is expected when services are rendered.
You will be provided with a "superbill" that includes the insurance coding needed for reimbursement at the end of your appointment. You have to submit it yourself to your Insurance Company or apply it toward your flex spending account. It is suggested that you verify that your benefits include out-of-network reimbursement.

Please note it is the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage.

Do I have nutritional counseling coverage on my insurance plan?

If the insurance company asks for a CPT code please provide them with the following codes 97802 & 97803. 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. We also can bill for S9470 if it is covered on your policy.

Will my diagnosis be covered?

If the representative asks for a diagnosis code (aka ICD 10 code) – please tell them the visit is coded the ICD 10 code: Z71.3
If they don’t accept Z71.3 then provide them with Z72.4 and see if they will cover that diagnosis instead on your plan.
If you are overweight, obese, have pre-diabetes, diabetes, hypertension, or high cholesterol you may want to see what your coverage is for these diagnoses as well.
We always code your visit using preventative coding (if applicable) to maximize the number of visits you receive from your insurance carrier. However, if you ONLY have a medical diagnosis (for example: IBS, and you are not overweight or have CVD risk factors) your insurance may impose a cost-share for your visit either in the form of a deductible, co-pay or co-insurance.

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 vary from 0 to unlimited depending on medical need.

Do I have a cost-share for my nutrition visit?

A cost-share is the amount you will need to pay as required by your particular insurance plan towards your services. A cost-share can be in the form of a deductible, co-pay or co-insurance.
We will always bill under your insurance policy’s plan under your preventative benefits if your plan allows. With that being said, if you have preventative benefits there if often NO cost share for you associated with the visit. Once again, this is something YOU do want to ask prior to your visit.
In the event you have a cost-share we will initially bill your insurance company directly. Once we receive the EOB describing your responsibility as the patient, we will bill the credit card on file for the amount noted under ‘patient responsibility.
For most insurance companies dietitians are considered a specialist. 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. However, often because we bill your insurance with preventative counseling the co-pay is often not applicable.

Summary of questions to ask to verify your nutrition benefits

Do I have coverage for nutrition counseling?
Do I need a referral to see a Registered Dietitian?
Are my diagnoses covered on my particular plan?
How many visits per calendar year do I receive?
Do I have a cost-share for these services?
Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus in person visit?

CANCELLATIONS

Your treatment plan is designed to maximize continuous benefit for you. Missed appointments interfere with therapeutic momentum and can lessen the effect of therapy. However, we understand that, occasionally, circumstances arise that may require you to cancel an appointment. Note that a credit card is required to schedule your visit. This card will ONLY be charged if you don’t show up for your visit, cancel with less than 24 hours’ notice, or have an insurance cost-share (deductible, co-pay, or co-insurance) for your insurance-based visit.

Payment options will be discussed with your provider. Make payments securely online through PayPal, with or without a PayPal account. You can use your credit card or bank account. Payments are processed securely and your financial details remain private.