Verification of Nutrition Benefits
Please note that it is the responsibility of the patient to call their insurance PRIOR to your visit to confirm coverage. I don’t want our patient’s to have any surprise bills!
Did you know that many health insurance companies will reimburse for nutritional counseling?
To learn about your coverage, call the 800 phone number on the back of your insurance card and ask to speak with a representative. The information below will walk you through the steps to take to see if your insurance will reimburse you the cost of nutrition counseling for your visit and I can provide you with a Superbill to submit! You will be required to pay for the nutrition visit upfront using a credit card or FSA/HSA card.
What questions should I ask when calling my insurance company?
Do I have nutritional counseling coverage on my insurance plan?
If the insurance company asks for a CPT code please provide them with the codes 97802 & 97803. If they say you do not have coverage using those codes, NEXT ask them to check your coverage for the CPT codes: 99401, 99402, 99403 and 99404.
Will my diagnosis be covered?
If the representative asks for a diagnosis code – We can provide you with the Physician Referral ICD 10 code or ICD 10 code: Z71.3. We always try to code your visit using preventative coding to maximize the number of nutrition visits you receive from your insurance carrier.
Will your nutrition visit be covered if it a telehealth visit?
Make sure to ask the representative your coverage for telehealth visits. We will usually code using a Modifier 02 or 95 depending on your insurance.
How many visits do I have per calendar year?
The representative will let you know how many visits they are willing to cover or reimburse you. Depending on your particular insurance the number of visits can 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.
We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.
Have I met my deductible?
In the event you have a deductible and have not met it you will likely not get reimbursed but don’t forget to ask.
What’s next?
Remember to write down the codes your insurance company will potentially cover if we submit to your insurance or I can provide you with a Superbill that will help with your reimbursement! Provide me with those codes when scheduling your appointment.
Still have questions? No problem! Email billing@feeding5nutrition.com