Insurance

Nutrition for Daily Living currently accepts Medicare, Blue Shield of California and Anthem Blue Cross plans. It is your responsibility to know your nutrition counseling coverage.

 

Medicare covers your nutrition visit only if you a have diagnosis of diabetes or chronic kidney disease (stage 3, 4 or 5). All other diagnosis you will charge our prompt pay fee.

BlueShield of California and Anthem Blue Cross has many different polices across California as well as the US. It is important to know what your plan covers. See the tips below for how to verify if your insurance covers your nutrition visit.

 

If I am not in network with your insurance company our prompt pay fee is due at the time of service. I can provide you with a superbill to submit to your insurance company to request reimbursement.

 

How do I determine if have nutritional counseling coverage on my insurance plan and how do I verify this?

 

1.        Call your insurance company prior to your appointment to verify your coverage. You can find this number on the back of your insurance card.

2.        Ask the insurance company to verify your coverage for nutrition services. If insurance company asks for a CPT code (a procedure code)- please provide them with the following codes 97802 & 97803.

3.        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. 

 

Will my diagnosis be covered?

4.        When talking with the insurance representative, ask what diagnosis codes (ICD 10 codes) are covered?

5.        Ask if insurance coverage provides preventative or only medical benefits. This can determine if you have a copay or share of cost.

6.        Ask if ICD 10 code: Z71.3 is covered.  If you have the diagnosis of overweight, obesity, pre-diabetes, diabetes (specify type), hypertension, or high cholesterol, IBS, etc. you may want to see what your coverage is for these diagnoses as well. 

 

How many visits do I have per calendar year?

7.        The insurance representative should let you know how many visits they cover. Depending on the carrier the number of visits vary from 0 to unlimited depending on medical need.

 

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

·      A cost-share is the amount you will need to pay for your nutrition visit, as required by your insurance plan. A cost-share can be in the form of a deductible, co-pay or co-insurance.  In the event you have a cost-share we will initially bill your insurance company directly.  Once we receive your explanation of benefits (EOB), describing your responsibility as the patient, we will bill the credit card on file for the amount noted under ‘patient responsibility’.

·      We generally wait for the claim to be processed to determine if a co-pay is required and then send you an invoice or charge the credit card you have on file with us for the co-pay amount. We do our best to communicate with you any anticipated changes so there will be no surprises.

 

Please note, it is your/the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage - we don’t want YOU to have ANY surprise bills.

 

Summary of Questions to Ask Your Insurance Company

  • Do I have coverage for nutrition counseling?

  • Are my medical diagnoses covered on my insurance plan?

  • How many visits per calendar year do I receive?

  • Do I have a cost-share for these services?

  • Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus in person visit?

 

If you have any questions after verifying your benefits, we are happy to help. Please email christine@nutritionfordailyliving.com or call 530-588-0655. We will return your message within 48 business hours.