Is your insurance is covered?

Most insurance plans will cover nutrition counseling and medical nutrition therapy. Often times, our services are covered at 100%–HOORAY! Here at NutriCare Wellness, 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.

How Does Insurance Work?

Step #1
Locate the member services/customer service number on the back of your card.

Step #2
Call the Customer Service number and explain to them that you need to verify “Virtual Nutrition Counseling Benefits”. Here are questions to ask:

1. Is my provider in-network or out-network? Do I have out-of-network benefits? Yes, what percentage if covered?
Here is our provider information to check if she is in-network with your plan.

Tax ID# 871682819

Group
NutriCare Wellness, LLC-NPI # 1114599479

Individuals
Preeti Soni-NPI # 1821668336

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. Often times, you will receive a full refund. *Please note that some insurance companies will reimburse you directly.

2. Does my policy cover nutrition counseling and/or medical nutrition therapy?

See if these CPT codes are billable:

• 97802 & 97803
• S9470 (most common for BCBS)

3. What conditions and/or diseases are covered? (ICD-10 Codes)

• Z71.3- Healthy Eating
• E11- Diabetes 2
• 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)
• R73.09- Abnormal Blood Glucose (Pre-diabetes)

4. If so are there a limit on the number of allowed visits per year?

5. What is my cost?

6. Do I have a deductible?
Do I have a deductible for Nutritional Counseling services? If yes, how much is it and how much has been met so far?

7. Do I have a co-pay or what is the percentage of coverage?

8. Do I have a coinsurance?
*Often times with preventive counseling, there is no out-of-pocket cost.

9. How many visits do I get?
Tip: When does my plan renew? January or which month?

10. 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 emailed to us at info@nutricarewellnessrd.com. Be sure to follow up with us to ensure that we received it.

11. Where can services be rendered?
Can be in the office or through Telehealth (over the phone).

12. What is the reference number for this call?
You must get a reference number. At times, the benefits stated don’t reflect what happened to the claim. Getting the reference number will help in case of a denied claim.

13. Are there any restrictions and/or limitations to my coverage? ie does my plan cover preventative “medically necessary” visits, or does it also allow and cover services such as a primary diagnosis?

Note: You will be responsible for any visits which your insurance carrier denies payment.

Step #3
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.

*Medicare
In-Network.