Coverage varies greatly between plans. If insurance declines to cover your visit(s) for any reason, you are responsible for the full amount billed. I recommend contacting your insurance directly to verify coverage before your first appointment. If you are planning on receiving out-of-network reimbursement for medical nutrition therapy, you are responsible for payment at the time of your service.
Even as an out-of-network provider, it is possible that your insurance company will cover all or a portion of nutrition visits. I recommend that you contact your insurance provider to clarify coverage.
If requested, I will provide a Superbill with a procedure code and diagnosis code for you to submit to your insurance company for reimbursement.
PHONE SCRIPT WHEN CALLING YOUR INSURANCE COMPANY:
- Is nutrition counseling covered? (the procedure codes are 97802 and 97803)
- Are there restrictions on which diagnoses are covered?
Is Z71.3 (dietary counseling and surveillance) covered, or is a medical diagnosis required?
- Do I need a referral or prior authorization?
- Is nutrition counseling covered when provided via telehealth?
- How many visits are allowed?
- Is there a time limit for each session?
- Do I have a deductible to meet before insurance pays? If so, is the deductible waived for preventive nutrition therapy?
- Will I have a copay or coinsurance?
- Is Nutrition Elevated, PLLC covered under my plan? (they will likely ask for the provider’s NPI listed below)
Lauren Rice’s NPI 1: 1609386390 and NPI 2: 1386319861
- Write down the date and reference number for your call.
HSA/FSA CARDS AND ACCOUNTS
If your insurance plan does not cover nutrition counseling but you do have a Health Savings Account or Flexible Spending Account (HSA/FSA) card, you can use that to pay for your sessions.