Even though we pay for our insurance each paycheck, they don't make it very easy for us to understand what benefits we have or the cost of service. During your discovery call, I always ask my clients if they have verified insurance coverage and many do not know how to do this so here is a guide so that you can easily figure out if dietitian visits are included in your plan and what your exact benefit is.
Confirming In-network Benefits (Blue Cross Blue Shield and Mass General Brigham Health Plan):
Do I have coverage while working with a Registered Dietitian who is in-network? (you can provide the practice name: Dana J. Fryer Nutrition, LLC; dietitian’s name: Dana Fryer, RD; dietitian’s NPI # 1568061844)
Do I refer a referral from my PCP?
Are the following diagnosis codes: Z71.3 and procedure codes: 97802, 97803, 97804 covered?
How many sessions are covered per plan year? Do I have a deductible to meet first? If so, how much is it? Do I have a copay?
Do I have coverage for telehealth? (HIPAA secure video conferencing) *Please note all Dana J. Fryer Nutrition Appointments are telehealth*
Record the representative's name and a reference # when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.
Confirming Out-of-network Benefits (all other plans):
Do I have coverage while working with a Registered Dietitian who is out-of-network?
Do I refer a referral from my PCP?
Are the following diagnosis codes: Z71.3 and procedure codes: 97802, 97803, 97804 covered?
Do I have coverage for telehealth? (HIPAA secure video conferencing)
Do I have a deductible to meet first? If so, how much is it?
Ask where you can submit a superbill for reimbursement - fax, email, mail?
Record the representative's name and a reference # when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.
If your insurance does not provide coverage for dietitian services a superbill can be provided for you to submit to your insurance company. Paying privately is also an option for those without insurance coverage or if there is a desire to add additional visits past those covered by insurance.
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