ASK YOUR INSURANCE

Questions to Ask Your Insurance Company

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Because every insurance plan is different, we recommend contacting your insurance company before your first appointment. Call the Member Services phone number on the back of your insurance card and ask:

Coverage

• Do I have out-of-network benefits for Medical Nutrition Therapy (MNT) provided by a Registered Dietitian Nutritionist (RDN)?

• Does my plan cover nutrition counseling for my diagnosis or reason for seeking care?

• Is a physician referral or prior authorization required?

• Is there a limit on the number of nutrition visits covered each year?

Costs

• Does my out-of-network deductible apply?

• Has my deductible already been met?

• After my deductible, what percentage of the visit will be reimbursed?

• Is reimbursement based on the billed amount or the plan's "allowed amount"?

Billing

• Are the following CPT codes covered?

  • 97802 – Initial individual nutrition assessment

  • 97803 – Follow-up individual nutrition counseling

• Are there any diagnosis (ICD-10) requirements for reimbursement?

Submitting a Superbill

• How do I submit my superbill (online member portal, mobile app, mail, fax, or another method)?

• Is there a deadline for submitting claims?

Reimbursement

• Approximately how long does reimbursement usually take after my claim is submitted?

• How will I receive reimbursement (check by mail, direct deposit, or another method)?

• Can I track the status of my claim online?

Pro Tip

• When you speak with your insurance company, ask for the representative's name and a reference (or call confirmation) number for your conversation. Keep this information with your records.

• If you have questions later about your benefits or reimbursement, having the reference number makes it much easier for the insurance company to locate the details of your call.

• You may also want to write down:

  1. The date and time of your call

  2. The representative's name

  3. Any important details they provided about your coverage or reimbursement

What We'll Provide

After your appointment, we'll provide a superbill that typically includes:

• Registered Dietitian provider information

• National Provider Identifier (NPI)

• Diagnosis (ICD-10) code

• Procedure (CPT) code

• Date of service

• Amount paid

You can then submit the superbill directly to your insurance company according to your plan's reimbursement process.

Please Note

Insurance reimbursement is determined solely by your insurance plan. We cannot guarantee coverage, reimbursement, or the amount reimbursed. Payment for services is due at the time of your appointment, regardless of your insurance benefits.