Insurance is tricky. Reimbursing yourself for the fees paid for my appointments will depend on the terms of your individual plan at the time of your appointment. I strongly recommend verifying your out of network benefits before our first appointment. The below script can't guarantee reimbursement, but it can guide the conversation with your insurance company to help avoid surprise out of pocket costs.


Call the member services phone number on the back of your insurance card. Write down the representative's name and reference number for your call. Ask and write down the answers to the below:

Does my plan include a benefit for outpatient Medical Nutrition Therapy (MNT) or nutrition counseling with an out of network provider? The CPT codes 97802 and 97803.

What percentage of the cost of service does my plan cover for out of network MNT or nutrition counseling?

Does my plan cover MNT for health maintenance (diagnostic code Z71.3) or do I have coverage only when I have certain diseases or conditions?

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Does my plan cover Telehealth or only in person visits?

Will I need a doctor's referral? Will I need preauthorization?

How many sessions (or hours) am I allowed in a calendar year?

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How much is my deductible? How much of my deductible have I met? Will I need to pay out of pocket for this service until I have met my deductible?

 

Do I have a co-pay or co-insurance I will need to pay out of pocket at the time of service?