Your insurance policy may cover your visits.
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We are currently an in-network provider for:
BCBS Wyoming (this includes BCBS Federal and other BCBS PPO plans)
Cigna
Aetna
United Healthcare/UMR *Note: doctor referral is required at the time of visit
We bill under Preventative Wellness commonly using diagnosis Z71.3 and procedure codes 97802/97803. Most plans provide coverage without copays or coinsurance, but we encourage a benefits check to confirm how many sessions are included in your plan before we begin working together.
Advanced services or tests may have out-of-pocket fees. We are always transparent about costs up-front, so don’t hesitate to ask any questions.
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In the event that you are unable to be seen in office, telehealth services are offered to residents of:
· Wyoming
· Arizona
· Colorado
Your insurance may or may not provide reimbursement for telehealth services. -
If we do not participate with your insurance provider, there are a couple of options:
Clarity / Discovery Call - FREE
15-minute introductory call to discuss your goals and see if we’re a good fit.Self-Pay Initial Assessment - $200
75-minute comprehensive nutrition evaluation, including personalized recommendations and goal setting.Self-Pay Follow-Up Sessions
60 minutes - $150
45 minutes - $120
30 minutes - $80
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Please note it is the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage. If your claim is denied for lack of nutrition coverage, you will be charged full price for the initial or follow up assessment.
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. We also can bill for S9470 if it is covered on your policy.
Will my diagnosis be covered?
If the representative asks for a diagnosis code (aka ICD 10 code) – please tell them the visit is coded using 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.
We always code your visit using preventative coding (if applicable) to maximize the number of visits you receive from your insurance carrier. However, if you ONLY have a medical diagnosis (for example: IBS, and you are not overweight or have CVD risk factors) your insurance may impose a cost-share for your visit either in the form of a deductible, co-pay or co-insurance.
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.
Do I have a cost-share for my nutrition visit?
A cost-share is the amount you will need to pay as required by your particular insurance plan towards your services. A cost-share can be in the form of a deductible, co-pay or co-insurance.
We will always bill under your insurance policy’s plan under your preventative benefits if your plan allows. With that being said, if you have preventative benefits there is often NO cost-share for you associated with the visit. Once again, this is something YOU want to ask prior to your visit.
In the event you have a cost-share we will initially bill your insurance company directly. Once we receive the EOB describing your responsibility as the patient, we will bill the credit card on file for the amount noted under ‘patient responsibility.
For most insurance companies dietitians are 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, since we often 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.
Summary of questions to ask to verify your nutrition benefits:
Do I have coverage for nutrition counseling?
Do I need a referral to see a Registered Dietitian?
Are my diagnoses covered on my particular plan?
How many visits per calendar year do I receive?
Do I have a cost-share for these services?
Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus in person visit?
Did you know that many health insurance companies cover nutritional counseling? Why not check to see if your insurance policy will cover your visits? Start by calling the 800 number on the back of your insurance card and ask to speak with a representative.