Do you want to use insurance for your nutrition visit?

Questions About Using Insurance

• What insurance companies do Nutrition for Autoimmunity participate with?

  At the present time, I am now a preferred provider with Anthem, BCBS, Cigna, Regence, UMR, United HealthCare.

   

• What insurance policies are not accepted/secondary insurance policies?

  Nutrition for Autoimmunity DOES NOT participate in

  • Kaiser Permanente
  • Medicaid (OHP)
  • Medicare
  • PacificSource
  • Moda

  Secondary insurance will be billed only when both primary and secondary plans are in-network; otherwise, the patient remains financially responsible for any unpaid balance.

• If I live far away, can I use my insurance for telehealth visits with Stephanie?

  Most insurance companies still cover telehealth services. Therefore, when you schedule your visit you will be directed towards the next steps to setting up properly for your telehealth session. However, it is possible your insurance plan may impose a cost-share for you to use this service. Please call your insurance company to confirm your telehealth coverage PRIOR to scheduling your visit.

• What happens if you do not participate with my insurance?

  If your claim is denied due to a lack of nutrition coverage, you will be responsible for paying the total amount of the claim. However, Nutrition for Autoimmunity does accept HSA/FSA and all major credit cards. In addition, if you are not planning on submitting to insurance, discounts are available.

• What questions should I ask when calling my insurance company?

  Please note it is the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage. We sound like a broken record – we don’t want our patients to have ANY surprise bills.

   

  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 and 97803.

   

  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 varies from 0 to unlimited depending on medical need.

   

  Will my diagnosis be covered?

  • If the representative asks for a diagnosis code (aka ICD 10 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 your plan will cover that diagnosis instead.
  • 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: Hashimotos, 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.

   

  Do I have a cost-share for my nutrition visit?

  • A cost-share is the amount you must 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 it. 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 do 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 specialists. 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.