We are contracted providers with Blue Cross Blue Shield and Cigna!
If we are not in-network with your insurance company we can provide you with a superbill, at your request, for potential reimbursement.
Please understand that your insurance policy is a contract between you and your insurance company. We do not check benefits for patients so it is your responsibility to know what your plan covers and what your portion of the cost is.
To verify your insurance benefits for nutrition counseling, please call the number on the back of your insurance card and ask them the questions below. Doing this before you attend your first appointment for nutritional counseling will help ensure you get the most out of your benefits and avoid unwanted financial surprises.
- Do I have benefits for nutritional counseling, CPT codes 97802, 97803, G0270, 99404, or S9470?
- Do I have any nutrition counseling benefits covered under the preventative care portion of my plan?
- Is a doctor’s referral required? (usually only required with Medicare and Medicaid)
- Is there a limit on the number of visits I am allowed?
- Are there any restricted diagnoses?
- Do I have a deductible to meet before insurance pays?
- Do I have a co-pay or co-insurance once my deductible is met?
Check out the FAQs below and our blog post How to Determine if Your Insurance Covers Dietitian Visits to learn more! If you have any additional questions, please contact us.
What happens if you do not participate with my insurance?
Currently, we are only in contract with Blue Cross Blue Shield and Cigna. However, this does not guarantee that your plan covers dietitian visits.
Therefore, you are required to call your insurance company prior to scheduling your visit to confirm your nutrition visits will be covered.
Please follow the steps below ‘What questions should I ask when calling my insurance?’
In the event, your claim is denied for lack of nutrition coverage our initial visits (60-minutes) are $150.00 and each follow-up visit (60-minutes) is $120.00. LANA accepts cash, check, HSA/FSA cards and all major credit cards.
What questions should I ask to confirm my insurance coverage?
Please note it is the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage. We ask this of you because we don’t want our patients to have ANY surprise bills.
Q1. 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 & 97803. If they say you do not have coverage using those codes NEXT ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404. We also can bill for S9470 if it is covered on your policy.
Q2. 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 they will cover that diagnosis instead on your plan.
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: IBS, 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.
Q3. 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 vary from 0 to unlimited depending on medical need.
Q4. Do I have a cost-share for my nutrition visit?Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus in person visit?
A cost-share is the amount you will need to 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.
With that being said, if you have preventative benefits there if 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 a specialist. 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.
If you have any questions after verifying your benefits we are happy to help. Please email us at info@lanutritionassociates.com.
What happens if your claim is denied:
Again, please note, it is the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage. We ask this of you because we don’t want our patients to have ANY surprise bills.
Currently, we are only in contract with Blue Cross Blue Shield and Cigna. However, this does not guarantee that you have coverage for dietitian visits.
In the event your claim is denied for lack of nutrition coverage, you will be responsible for payment. Our initial visits (60-minutes) are $150.00 and each follow-up visit (60-minutes) is $120.00. LANA accepts cash, check, HSA/FSA cards and all major credit cards.