Most BCBS plans often cover 100% of visits with no copay, no deductible, and no maximum visit limit.
Super Bill is provided if you hold other insurance like AETNA, UHC, or CIGNA.
To verify your nutrition coverage please call the 800 number on the back of your card and ask to speak with a representative from member services. You must check insurance coverage before coming in for your appointment. Even if you have an excellent insurance policy it does not mean you have coverage for nutritional services.
The provider for the visit is Aarthi Pauldass, RD. Please ask the representative the following questions:
Do I have nutrition services on my current insurance policy?
If yes, please ask them if the following CPT codes are covered: 97802 (initial appointment) & 97803 (follow-up appointments).
If they say you do not have coverage using those codes, NEXT ask them to check your coverage for the following CPT codes: 99401 through 99404.
Ask the representative if the following diagnostic code, also known as an ICD 10 code is covered: Z71.3 for medical nutrition therapy/ nutritional counseling.
If not, ask what diagnoses or diagnostic codes are covered under your plan. If you have one of the diagnoses, we will need a direct referral from your doctor with the applicable ICD 10 code for that diagnosis.
Ask if you need a referral from your doctor.
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 from your doctor and have it faxed to us at 866-264-6737. We must have the referral BEFORE your first appointment in order for your visit to be covered.
How many covered visits do I have per calendar year?
What is considered a calendar year for my current policy?
Do I have a co-pay or deductible for nutrition services?
You will be asked to pay any applicable co-pays and/or deductibles at the time of your visit. You will also sign a liability waiver stating that you will be responsible for the charges if your insurance does not cover the visit.
Note – We will be taking a credit card number on your first visit. In the event your claim gets denied by your insurance company (or if you have an outstanding co-pay/deductible) your credit card will be charged for the visit.
The initial visit is $120.00 and lasts around 60 minutes. Each follow-up lasts around 30 minutes and costs $80.00. Therefore, please make sure to verify your insurance PRIOR to your visit.
What happens if you participate with my insurance provider – but when I called the insurance they told me I have a yearly deductible I have not met.
In the event you have a deductible we will not be able to initially bill your insurance company directly. Therefore, payment of $120.00 is due at the initial visit and $80.00 is due at each follow-up visit. We will provide you will 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, we can then directly bill your insurance company.
What happens if I have insurance that you do not participate with?
In the event you carry insurance that we are considered out of network (United, Cigna, and Aetna) you will need to pay for your counseling session at the time of service. We are happy to provide you with a “Superbill” to help you get reimbursed from your insurance company.
A physician referral is NOT required if you are seeing me for preventive health like prediabetes, high blood pressure, high cholesterol, or obesity weight management.
While I may not participate with other insurances, I can still provide you with the official documentation you need for reimbursement. The best way to know whether or not they should expect reimbursement is to verify their MNT benefits before your visit with me. You can do this by calling the 800 number on the back of their insurance card and asking to speak to a representative. At the same time of the call, you should also ask about the directions for submitting the superbill. Get a reference code for your conversation with the representative you speak with at your insurance company.
What forms of payment do you accept?
We accept credit cards only
Where are you located?
We are a 100%, telehealth provider. We offer telephone or video visits only.
Wrap up – Things to do before my nutrition visit
Verify your insurance benefits with your insurance company.
Book your appointment using the link below.
Be prepared to provide a credit card which will be kept on file in a safe, secure locked location.
Fill out the Patient Demographics-Insurance sheet PRIOR to your visit. It will be sent to you at the time of booking.
