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  • Home
  • Services
    • Insurance Based Visits
    • Functional Testing
    • Corporate Wellness
    • Consulting Services
    • Supplements
  • Classes
    • May 17, 2022 - PCOS
    • 5 Day Metabolism Challenge
  • Resources
    • Meal Plans
    • Recipes
    • Monthly Blog
  • Contact
    • Contact
    • Book Now
    • Client Portal
    • Our Team
    • Discovery Call
Book Insurance Visit


Most health insurance companies cover nutrition counseling under preventative health, so often times that means $0 out of your pocket!  
We are in-network with: Blue Cross Blue Shield/Anthem, Humana, Medicare (they ONLY cover diabetes and kidney disease), Molina Health, United Healthcare, Sana, Superior Health (Ambetter).  
Step 1: Call your Insurance to verify nutrition counseling (scroll down for all the questions to ask)
It is important you call to understand your insurance plan benefits, limits, coverage and options. We share benefit coverage based on prior insurance validations, but if all or part of our services are not covered under your plan or apply to your deductible, you will receive a bill for the balance.  We charge $140/hr for nutrition therapy.    If you do not have coverage, we do have some great packages and monthly subscriptions to help you on our journey at discounted rates!
Step 2: Obtain a Referral if you  have a HMO plan or Medicare
HMO: This should come from the Primary Care Physician and if you have a HMO this is generally done in an electronic system and we recommend asking for 14 visits over 6 months.  If they need an NPI number for your practitioner find it here.   
Have your physician fax a copy of the electronic referral to us with a copy of your medical diagnosis, chart notes, and labs.
MEDICARE This can come from any physician or nurse practitioner, however they only cover nutrition counseling for diabetes and kidney disease.  You can use this form to share with  your physician and have them fax back the form with a copy of any medical diagnosis codes, chart notes, and labs.
Step 3: Book a Session in our client portal.
​This system requires a credit card to hold your reservation in case of copays, cancellation fees, or optional add on services.
Step 4: We handle the billing.
Our system will manage the billing and if there is a copay we will charge the card on file (this is very infrequent).  If there is a denial, we will resubmit and be in contact if we see any issues.  

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:
​

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 or Z72.4 (these are the most common). 
Have ready any other medical diagnosis ICD-10 Codes for any other medical conditions you have, that have been diagnosed by a physician (see reference document below).


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.

We suggest you record the date, time and name of the representative and keep this information for your records.
Date: _______________________ Time: ________________________
Name of Rep: ______________________________________________
Ref. # __________________________
diagnosis_codes_for_nutrition_therapy.pdf
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File Type: pdf
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Email Us
713.588.6222 (Houston Office)
​210.201.4442 (San Antonio Office)
​ 1.855.731.1379 (fax)
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