Health Insurance for Nutrition Services
Your insurance policy may cover the visits.
Why not check to see if your insurance policy will cover the visits? Start by calling the 800 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 cover the cost of nutrition counseling for your visit.
What insurance companies does Amy and her team participate with?
At the present time, Amy and her entire team are preferred providers with Medicare, Cigna, Connecticare, Harvard Pilgrim Health Care, United HealthCare and Anthem Blue Cross and Blue Shield. Medicare only covers the visit if you have diabetes or renal disease. Medicare DOES NOT cover for nutritional counseling for pre-diabetes at this time.
I live far away, can I use my insurance for telehealth services with Amy and her team?
Right now due to the pandemic most insurances are covering for telehealth services. Therefore, when you schedule your visit you will be directed towards the next steps to setting up properly for your telehealth session.
What happens if you do not participate with my insurance?
Amy and her team members don’t currently participate with Aetna.
In the event that you carry insurance that we are considered out of network (Aetna-only) you will need to pay for your counseling session at the time of service.
We are happy to provide you with a “Superbill” and/or an itemized invoice you can submit to your insurance company for reimbursement. Reimbursement is based on your policy’s standards. Please call your insurance company’s member services number to verify how reimbursement works under your current insurance policy.
Please note if you do have an insurance which considers Amy as out-of-network, Amy cannot submit directly on your behalf – she can only supply you with the appropriate paperwork. Therefore, payment is due at the time for service directly payable to Amy Plano, RD.
Initial visits are $180.00 and each follow-up visit is $80.00. Amy accepts cash, check and all major credit cards.
What questions should I ask when calling my insurance company?
with Do I have nutritional counseling coverage on my insurance plan?
- If the insurance company asks for a CPT code please provide them with the following codes 97802 & 97803. If they say you do not have coverage using those codes NEXT ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404.
Will my diagnosis be covered?
- If the representative asks for a diagnosis code – please tell them the visit is coded the ICD 10 code: Z71.3
- If they don’t accept Z71.3 then provide them with Z72.4 and see if they will cover that diagnosis instead on your plan.
- If you are overweight, obese, have pre-diabetes, diabetes, hypertension, or high cholesterol you may want to see what your coverage is for these diagnoses as well.
- I always code your visit using preventative coding to maximize the number of visits you receive from your insurance carrier.
How many visits do I have per calendar year?
- Your carrier will let you know how many visits they are willing to cover. Depending on the carrier the number of visits vary from 0 to unlimited depending on medical need.
Have I met my deductible?
- In the event you have a deductible I will not be able to initially bill your insurance company directly. Therefore, payment of $180.00 is due at the initial visit and $80.00 is due at each follow up visit.
- I 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, I can then directly bill your insurance company.
Do I have a co-pay for nutritional counseling?
- For most insurance companies I am 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.