Insurance and Payment Information
Insurance Information
We are currently in-network with most Cigna, Aetna, and United Healthcare plans.
Please verify your insurance benefits prior to your first visit as your coverage could have specific qualifications, limitations, and exceptions.
If using insurance for coverage of visits, claims will be billed to your insurance company. In the event that coverage is not met, or a co-pay is needed, you will be invoiced and charged to the payment method on file.
Any payments that are rejected or insufficiently funded will be the client's responsibility to cover within 30 days of receiving written notice.
Self-pay options:
If your insurance will not cover your nutrition visit or you have health insurance which we do not participate with, the cost of the initial 60-minute visit is $200 and each 50-minute follow-up visit is $100. Payment is due in full at the end of each session.
HSA/FSA, credit, and debit cards are acceptable forms of payment.
Self-pay rates:
Initial 60 Minute Assessment: $200
Follow-up Sessions: $100
Out-of-network benefits:
If you have out-of-network insurance benefits, these may apply to nutrition services. If so, you would pay us directly and then we provide you with a Superbill receipt that you can submit to your insurance company. Depending on your benefits, you may be able to receive full or partial reimbursement for your nutrition counseling sessions.
How to Verify Insurance Benefits
Call your insurance company before your appointment to confirm your coverage. The phone number for customer service is generally located on the back of your insurance card.
Once you are connected to the benefits department ask the following questions:
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 and 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.
Will my diagnosis be covered?
If the representative asks for a diagnosis code (ICD 10 code) – please tell them the visit is coded the ICD 10 code: Z71.3
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.
If you are seeing us for Eating Disorder support, please ask about F50.0-F50.9 codes specifically. These typically require a physician referral.
How many visits do I have per calendar year?
Your carrier will let you know how many visits they are willing to cover.
Do I have a copay or cost share?
If you have preventative benefits there if often no copay or cost share associated with the visit. However, this is something you want to confirm prior to your visit.
Do I need a physician referral?
If your plan requires a physician referral please let us know and we will submit it to your provider.
If you have any questions please email me at shannonscottnutrition@gmail.com