CHEF CRAFTED NUTRITION
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  • Home
  • Virtual Sessions
    • How it Works?
    • What We Treat
    • Insurance Coverage
    • Pricing
  • Enhancements
    • Meal Plans
    • Functional Testing
    • 20% Off Supplements
  • Our Team
  • Book Now

Insurance Coverage & Verification

Please make sure you review the coverage on your insurance policy and fully understand your plan benefits and requirements.
B
eing in-network with your insurance company does not guarantee coverage for nutrition counseling service.
​Please verify and understand your specific plans coverage for medical nutrition therapy as we charge $160 per hour.
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 We bill most insurance companies directly, but can always do payment upfront and provide a superbill if you prefer to try to get reimbursement.   

Aetna
We are in-network and most plans cover our services at 100% with at least 10 visits per year.  You must have a physician referral for us to bill your insurance.
​
Blue Cross Blue Shield/Anthem
We are in-network and most plans cover our services at 100% many with unlimited number of visits.  Texas TRS plans get at least 10 visits per calendar year, without a specific medical diagnosis, we may be able to request up to 26 visits.


Cigna
We are OUT OF NETWORK, but bill direct and often times clients get coverage with a copay due.

Friday
We are in-network and are happy to bill them direct and have seen patients get 100% coverage

Humana
We are in-network and most plans have at least 3 hours of counseling covered at 100% for medical conditions. 
If you have a Humana medicare plan, please see medicare requirements.


Medicare
  We are in-network but can ONLY bill for diabetes and/or chronic kidney disease and you must have a physician referral.  If you do not have either of these two conditions, you will be self-pay or we can bill any secondary insurance plan. This includes any medicare plan administered by any of the main insurance providers listed on this page. 


Molina Health
We are in-network and most plans have been covered at 100% without a visit limit to date. 
 
United Healthcare/UMR
We are in-network and many plans cover our services at 100% 
If you have a United medicare plan, please see medicare requirements.

Sana
We are in-network with this provider and understand there is coverage for memebers as part of their preventative care offerings.

Superior Health (Ambetter)
We are in-network and most plans cover our services at 100% many with unlimited number of visits.  
We are not a medicaid provider and cannot bill any medicaid plans administered by Superior Health.

Tricare
We are a non-network preferred provider and will require a referral from any physician in order to bill for services as this is a requirement for us to work with clients under the care of a physician. 

Wellcare
​We are in-network, but as this is a Medicare plan, they ONLY cover diabetes or kidney disease.  


NO COVERAGE?
With minimal proof of medical need and financial hardship, we do offer a limited number of slots using a pay what you can afford model for sessions with a dietitian.



HMO Plans

HMO plans must have a referral from your primary care physician faxed to us prior to our session in order to bill your insurance. 
​ Physician Referral Form
If we are out of network and nutrition counseling is critical to success and management of your condition there may be an opportunity for you, us, and your physician to collaborate to file an appeal/preauthorization to request coverage for your medical condition.

How To Verify Your Insurance Coverage

Call the Member Services Number on the Back of your Insurance Card and provide them with the information below:
​We suggest you record the date, time and name of the representative and keep this 
information for your records.

Does my insurance cover nutrition counseling?
​Provide the following procedure code:
97802 - Procedure code for an initial nutrition counseling appointment
97803 - Procedure code for a follow-up nutrition counseling appointment

Will my plan cover nutrition counseling for (your health conditions)?
Provide an ICD-10 diagnostic code: Z71.3  (the most common).  
List of other common ICD-10 Codes for medical conditions that may be needed. 

Additional Questions to ask:
Do I have a deductible to meet first? □ Yes □ No         If yes, how much?______________
Do I have a co-pay or co-insurance? □ Yes □ No          If yes, how much? _____________
Do I have a limited number of visits? □ Yes □ No 
If yes, how many per benefit year? _______ & when does the benefit year start? ___________
Do I need a physician referral? □ Yes □ No
Does my plan cover telehealth □ Yes □ No
Will my plan cover nutritional counseling as part of my preventative health services under the Affordable Care Act or Health Care Reform? □ Yes □ No
​
ONLY IF PROVIDER IS OUT OF NETWORK, YOU SHOULD ASK THE FOLLOWING QUESTIONS:
Does my plan has coverage for Out of Network benefits? □ Yes □ No
Does my plan reimburse if I submit a superbill?  □ Yes □ No
If yes to either questions, ask all of the in network questions above to inquire about your out-of-network benefit coverages.


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