Does insurance cover my sessions?
Most insurance plans will cover nutrition counseling and medical nutrition therapy. Oftentimes, 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. Due to COVID-19 most plans are covering telehealth.
How Does Insurance Work?
Locate the member services/customer service number on the back of your card. 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?
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 the visit and you will be issued a refund once we receive payment from the insurance company. Oftentimes, you will receive a full refund. *Please note that some insurance companies will reimburse you directly.
ATTN: Medicare Members
We do participate with medicare. Please note at this time Medicare only covers visits for Diabetes and Chronic Renal Failure. This is the same for your supplemental insurance. If you do not have either disease, you will be provided with a medicare self-pay discounted rate.
You are also required to have your primary care provider (not a specialist) fax in a referral form (fax# 480-505-3077).
Not all of our providers participate in these programs. Currently, Nicole Goodrich and Christine Babey are our medicare providers.
2. Does my policy cover nutrition counseling and/or medical nutrition therapy?
See if these CPT codes are billable:
97803 (follow up)
You MUST ask if in-person and/or telehealth is covered for the codes.
Preventative VS Medical
There is a difference between preventive and medically necessary. You will want to ask what coverage looks like for both. Some policies will cover so many visits for preventative and more for medical.
AETNA: the 12 sessions for preventative require a doctor’s letter to obtain a pre-authorization. If you have a diagnosed condition (pre-diabetes, obesity, IBS, High cholesterol, see more below) you most likely do not need pre-authorization. Contact us for assistance.
What conditions and/or diseases are covered? (ICD-10 Codes)
- Z71.3- Healthy Eating
- E11- Diabetes 2
- R73.09- Abnormal Blood Glucose (Pre-diabetes)
- 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
- Find more diagnosis codes to use HERE.
3. What is my cost?
Level of coverage (coinsurance) 100%, 90%, 80% etc.
Is it subject to deductible
Is it subject to a copay
*Often times with preventive counseling, there is no out-of-pocket cost.
Is Anderson’s Nutrition in-network with my policy.
Tip: If you have an HMO, Medicaid, or work for a hospital system, oftentimes it may be a particular dietitian.
4. How many visits do I get?
Tip: When does my plan renew? January or which month?
5. 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 (833) 755-0838. Be sure to follow up with us to ensure that we received it.
6. What is the reference number for this call?
Make a note and include it in the Welcome form once you receive it.
Questions or having issues? Call us! 602-770-7611 or Email us
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 in contacting the insurance company if you have any questions.