Health Insurance and Nutrition Counseling Coverage Information + Physician Referral Form
Your insurance may cover your nutrition counseling session!
Did you know that many health insurances will cover nutrition counseling sessions? This is often the case even if you don’t have an actual diagnosis, but still want to meet with a dietitian for preventative nutrition counseling (ie: Intuitive eating, general healthful nutrition, family meal planning, etc.).
If you have been wanting to improve your nutrition habits, but haven’t been able to find the right nutrition plan that works for you and your lifestyle needs – why not check with your insurance to see how many visits they would cover?
Start by calling the 800 number on the back of your insurance card and ask to speak with a representative. Continue reading below to go through the steps to see if your insurance will cover the cost of your nutrition counseling for your visit with Samantha the Dietitian!
*Please note it is your responsibility as a client/customer to call your insurance provider to verify benefits and ask about coverage prior to meeting with a dietitian from OakStone Health and Nutrition. OakStone Health and Nutrition or the employees of OakStone Health and Nutrition are not responsible for verifying your insurance coverage prior to or after your scheduled nutrition counseling session.
What Insurance Companies Does OakStone Health and Nutrition Participate With?
At this current time, OakStone Health and Nutrition is an “in-network” provider with
- BlueCross BlueShield
- Humana Medicare Plans
- United Healthcare
- Virginia Premier (Pending)
Please note that not all plans will be covered even if your insurance is accepted, so calling your insurance company before scheduling an appointment is necessary.
What Happens If OakStone Health and Nutrition Does Not Participate With Your Insurance?
In the event that you use insurance that is considered out-of-network with OakStone Health and Nutrition, you will need to pay out of pocket for nutrition counseling at the time of service.
Samantha the dietitian will be happy to provide you with a “SuperBill” and/or itemized invoice that YOU can submit to your insurance company for possible reimbursement. Reimbursement is based on your specific insurance company’s policy standards. If you are interested in seeking nutrition counseling services and OakStone Health and Nutrition is out of network with your insurance, please call your insurance company’s member services number to verify how reimbursement works under your current insurance policy.
Please note: If you do have insurance that considers OakStone Health and Nutrition out-of-network, we cannot submit information directly on your behalf – we can only supply you with the appropriate paperwork. Because of this, payment is due at the time of service directly payable to OakStone Health and Nutrition.
We accept all major credit/debit cards, cash, and check. Payments will be processed electronically and safely. A credit or debit card is required to be on file in our electronic health record platform system prior to your initial nutrition counseling session and an up-to-date card must remain on file throughout the duration of your sessions.
Do I Need A Referral From My Doctor To See A Dietitian?
It depends on your insurance and their policies as to whether you will need a referral or not before starting nutrition counseling sessions. Some plans require an ORDER to be faxed to us. It never hurts to have a Primary Care Provider (PCP) fax over a referral to us at 1-866-422-7535.
In addition to the referral, we may also ask for the progress notes from your PCP so we can bill insurance accurately. As a dietitian, Samantha can not diagnose medical conditions, therefore must either bill for preventative counseling or use an existing medical condition from your PCP or other therapist.
Click here to download a copy of our referral form that you can give to your doctor at your next appointment!
I Don’t Live in Virginia But I Really Want to Work With You! Is This Possible?
At this time, we currently only accept clients that live in the state of Virginia due to licensure restrictions. We are able to see clients that are residents in the state of Virginia both in-person and via telehealth. If you live outside the state of Virginia, but still need the services of a dietitian, we can help you find one in your state that can meet with you.
What Questions Should I Ask When I Call My Insurance Company?
Do I have nutritional counseling coverage on my insurance plan?
If your insurance company ask for a specific CPT code, provide them with the following codes: 97802 & 97803
If they say you do not have coverage for either of those codes, ask them to check your coverage for the following codes: 99401 & 99404
Will my diagnosis be covered?
If the representative asks for a diagnosis code – please tell them the visit is coded in the ICD 10 code: Z71.3 (Dietary surveillance and counseling).
We code your visit using preventative coding when possible to maximize the number of visits you receive from your insurance provider. However, if you get a referral from a doctor and it lists a specific diagnosis (ie. Diabetes,Hypertension) then we will use that but code in a preventative manner.
How many visits do I have per calendar year?
Your insurance provider will let you know how many visits they are willing to cover. Depending on the insurance company that number of visits will vary from 0 to unlimited depending on medical need.
Have I met my deductible?
In the event that you have a deductible that has not yet been met, the cost of the session will go towards your deductible. However, you are then responsible for paying OakStone Health and Nutrition that amount. (For example, “X” insurance company said $XXX went towards your deductible for the nutrition counseling session. Since we did not receive any payment from your insurance that goes towards your deductible, you will be responsible for paying the full nutrition counseling session amount.)
Do I have a copay for nutritional counseling?
For most insurance companies I am considered a specialist. This information is often available on the front of your actual insurance card. Whenever possible we will try to bill for preventative nutrition so that a copay is not always required. Copays are due when we receive the EOB for the session and we will charge the credit card on file.
What is my reference number?
Please make sure to ask for and record the reference number of the conversation you just had with the insurance company. This will be helpful in case there are any difficulties with coverage.
Is Telehealth covered? And if so, is there a copay, and how many sessions do I get?
This is a question that you can ask if you are interested in telehealth services.
If you still have questions during this process, you can email us at email@example.com