Using Insurance


Is your insurance is covered?

Most insurance plans will cover nutrition counseling and medical nutrition therapy. Often times, our services are covered at 100%–HOORAY! Here at Anderson’s Nutrition, we do accept insurance. We will bill your insurance for you, however you are responsible to know and understand your benefits. See the questions below that you can use when contacting your insurance.

 

 

 

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 my provider in-network or out-network? Do I have out-of-network benefits?  Yes, what percentage if covered?

Here is a list of our providers and their NPI numbers to check if they are in-network with your plan.

Tax ID# 26-4506413

Group

Andersons Nutrition – NPI # 1508180829

Andersons Nutrition (Highmark) PA – NPI# 1396221347

Individuals 

Nicole Anderson Goodrich- NPI # 1194966879

Christine Babey- NPI # 1720380348

Jacqueline (Jamie) MacGibbon- NPI # 1578870424

Michelle Hines NPI # 1609938711

Andrea DaRosa NPI # 1932412152

Heather Gauthier NPI # 1528315900

Tammy Leeper NPI # 1225688013

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.

Out of Network– No problem! We are happy to bill your insurance even if you only have out-of-network benefits. The cost of the appointment will be collected from you at the time of visit and you will be issued a refund once we receive payment from the insurance company. Often times, you will receive a full refund.   *Please note that some insurance companies will reimburse you directly.

2.Does my policy cover nutrition counseling and/or medical nutrition therapy?

See if these CPT codes are billable:

  • 97802 & 97803
  • S9470 (most common for BCBS)

3. What conditions and/or diseases are covered? (ICD-10 Codes)

  • Z71.3- Healthy Eating
  • E11- Diabetes 2
  • E66.9- Obesity (BMI >30)
  • E78.5- Hyperlipidemia/High Cholesterol
  • K58.0/K58.9- IBS
  • E28.2- PCOS
  • K21.0- GERD
  • I10- Hypertension (high blood pressure)
  • K90.0- Celiac Disease
  • Z91.01- Food Allergy
  • R73.09- Abnormal Blood Glucose (Pre-diabetes)
  • Find more diagnosis codes to use HERE.

4. What is my cost? 

A. Do I have a deductible?

B. Do I have a co-pay?

C. Do I have a coinsurance?

*Often times with preventive counseling, there is no out-of-pocket cost.

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 faxed to us at 480-505-3077. Be sure to follow up with us to ensure that we received it.

7. Where can services be rendered? 

Can be in office or through Telehealth (over the phone).

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

Let’s get you scheduled! You will be e-mailed the forms prior to your appointment so please remember to add in your benefits summary that you checked on in Step 1.  For example: how many visits are covered, to which CPT and ICD-10 code.  We can always assist you on contacting the insurance company if you have any questions.

Questions or having issues?  Call us!

Western USA Scheduling– Schedule Online or Call 602-770-7611

Eastern USA  Scheduling– Schedule Online or Call 484-872-2909

*Medicare or Medicaid

Not all of our providers participate in these programs. If you are insured through either of them, be sure to tell us so we can get you in with a dietitian that participates.