Is your insurance covered?
While most insurance plans cover nutrition counseling and medical nutrition therapy, it is your responsibility to understand what your plan covers and what the portion of your cost is. The questions listed below can be used when you contact your insurance provider.
Due to COVID-19 most plans are covering telehealth.
How Does Insurance Work?
Step #1
Locate the member services/customer service number on the back of your card.
Step #2
Call your insurance company to check for benefits. Here are questions to ask:
1. Is Right Balance Nutrition in-network or out-of-network?
Right Balance Nutrition – NPI #1699228056
Aetna clients please use NPI #1518388131
Tax ID# 812996518
*If my NPI is not recognized or you are told is out of network, please ask the representative to verify the Tax ID
In-Network–We will bill your insurance directly and will bill you for any deductible, co-pay, or co-insurance that your insurance does not cover.
Do I have out-of-network benefits? Yes, what percentage if covered?
Out of Network– The cost of the appointment will be collected from you at the time of the visit. I can provide you a superbill (receipt) that you can submit to your insurance company for reimbursement.
2. Does my policy cover nutrition counseling and/or medical nutrition therapy?
See if these CPT codes are billable:
- 97802 & 97803
3. What conditions and/or diseases are covered? (ICD-10 Codes)
- E66.3 – BMI 25-30
- E66.9 – BMI >30
- K58.0/K58.9- IBS
- E03.9 – Hypothyroid
- Z71.3 – Diet surveillance / Healthy eating (ask specifically about this diagnosis code and if it’s covered as preventive)
- Are there any restricted diagnoses?
4. What is my cost?
- Do I have a deductible to meet before insurance pays?
- Do I have a co-pay? Does my copay apply to preventative benefits?
5. How many visits do I get?
Tip: When does my plan renew? January or which month?
6. Do I need a referral?
Many plans do not require a referral. However, if you do need a referral, be sure to call your primary care physician to get a referral sent to me. Be sure to follow up to ensure that I received it.
7. Where can services be rendered?
Is nutrition counseling covered when provided by a Registered Dietitian in an office setting or via telehealth? (note: Telehealth is not the same as telemedicine provided by an MD)
8. What is the reference number for this call?
You must get a reference number. At times, the benefits stated don’t reflect what happened to the claim. Getting the reference number will help in case of a denied claim.
Step #3
Contact Right Balance Nutrition to schedule your appointment or click this link to book online. Once your appointment is scheduled, you will receive intake forms through my patient portal for you to complete prior to your first session.