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Verifying Benefits

​I am in-network with Aetna, Blue Shield of California, Health Net, and United Healthcare. I am not in-network with HMO plans.

 

If you wish to use your insurance, it is your responsibility to call your insurance company before your first visit to verify that my services are covered under your plan (call the number on the back of your card). Coverage varies by insurance company and by plan. I do my best to get your appointments covered, but if your insurance rejects the claim I submit for any reason, the credit card I have on file will be charged at my self-pay rate ($175/55 minutes). 

Script:​

I’m calling to check my nutrition counseling benefits. 

  1. Is ____ diagnosis (e.g., high cholesterol) covered under MEDICAL benefits with CPT codes 97802 and 97803 (Medical Nutrition Therapy)?

    • Note that you'll get a more accurate response if you have an actual diagnosis code from your PCP (e.g. high cholesterol has many subtypes and each has its own diagnosis code).

  2. Is Z71.3 (Dietary Counseling and Surveillance) covered under PREVENTIVE benefits with CPT codes 97802 and 97803?

  3. Is nutrition counseling covered when provided via telehealth?

  4. How many visits are allowed? Are visit limits based on calendar year or term year?

  5. Do I have a deductible to meet before insurance pays? If so, how much of the deductible has been met?

  6. Will I have a co-pay or co-insurance?

  7. Is Center for Intuitive Eating/Fiona Young, MS, RD (NPI 1609478577) covered under my plan? If not, what are my out-of-network nutrition benefits? 

  8. Record the representative's name and the reference number, as this will be necessary if you ever need to dispute a rejected claim.

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