I accept PacificSource Health Plans, Regence, Asuris Northwest Health, Premera Blue Cross, Blue Cross Blue Shield, and Aetna.

Do I have nutrition counseling coverage on my insurance plan?

If you are asked for a CPT code, provide them with 97802 and 97803. If they say you do not have coverage using those codes, then ask them to check for coverage for 99401, 99402, 99403 and 99404. Lastly, check for coverage on S9470.

Will my diagnosis be covered?

If the representative asks for a diagnosis code (also known as a ICD 10 code), please tell them the visit will be coded with Z71.3.

IF they don’t accept Z71.3, then provide them with Z72.4 and see if they will cover that.

If you are overweight, obese, have pre-diabetes, diabetes, high blood pressure, or high cholesterol, you may want to see what your coverage is for these diagnoses as well.

I prefer to code your visit with preventative coding to maximize the number of visits you receive from your insurance company. However, if you only have a medical diagnosis (such as IBS, and you are not overweight or have CVD risk factors) your insurance may require a cost-share for your visit (such as a deductible, co-pay, or co-insurance).

How many visits do I have per calendar year?

Make sure to ask the representative how many visits per year they are willing to cover.

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. This will be a deductible, co-pay, or co-insurance.

I choose to bill under your policy’s preventive benefits as your plan allows. If you have preventive benefits, there is often no cost-share for you associated with the visit. Again, you will find this out during your call with the insurance carrier.

In the event that you have a cost-share, I will initially bill your insurance company directly. Once the explanation of benefits is received, I will bill the credit card on file for the amount noted under ‘Patient Responsibility.’

Most insurance companies consider dietitians as specialists. Therefore, your specialist co-pay is applicable and is payable at the time of service. This information is often on the front of your actual insurance card. However, often if your insurance is billed with preventative counseling the co-pay is not applicable.

Generally, I will 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 the co-pay amount.

At this point, I am only offering virtual services (telehealth). I do find that my patients find this fairly convenient. All services are offered via a HIPAA compliant platform (Practice Better).