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What questions should I ask my insurance provider?You MUST check insurance coverage before coming in for your appointment. Even if you have an excellent insurance policy it does not mean you have coverage for nutritional services. To verify your nutrition coverage, call the 800 number on the back of your insurance card and ask to speak with a representative from member services. First, you want to confirm that we are in your insurance network by telling the insurance agent that the provider is Kristen Lorenz NPI 1124784525. *If I am not in-network, please refer to the next FAQ answer* Do I have nutrition services on my current insurance policy? Please ask for the specific coverage for CPT codes 97802 and 98703. 97802 is covered 97802 is NOT covered 97803 is covered 97803 is NOT covered Is ICD10 Code Z71.3 covered? Yes No Does my plan cover telehealth services? Yes No Does my plan require a MD referral? Yes No How many MEDICAL MNT telehealth visits do I have per calendar year? ______ visits What is considered a calendar year for my current policy? ___________-to-__________ Do I have a deductible for nutrition services? If so, have I met my deductible? Yes, my deductible is $____ Yes, but I met my deductible No, I do not have a deductible Do I have a co-pay or co-insurance for nutritional counseling? Co-pay $_____ Co-insurance ___% Neither What is the reference number for the call? Reference #: _________________ Please note the reference number for the call- if there is an issue with billing, this reference number can be used to clarify any mistakes with your insurance provider.
What if you do not participate with my insurance provider?Right now, we are currently contracted with Cigna, Aetna and Medicare. However, some insurance providers may provide out-of-network coverage. Therefore, you should still call your insurance company to confirm if your nutrition visits will qualify for reimbursement. To verify your nutrition coverage please call the 800 number on the back of your insurance card and ask to speak with a representative from member services. You want to confirm that we are in your insurance network by telling the insurance agent that the provider is Kristen Lorenz, RD NPI 1124784525. Since the answer will be no, you'll want to ask what your out of network benefits would look like for the following: If I provide a superbill, can nutrition services 97802 & 97803 be reimbursed or applied towards deductible? If it does not go towards deductible, ask if code Z71.3 is eligible for reimbursement If yes, will you be eligible for reimbursement for telehealth visits? If yes, how many visits will be reimbursed per calendar year? In the event your claim is denied for lack of nutrition coverage my initial visits (60-minutes) are $260.00 and each follow-up visit (30-minutes) is $130.00.
If you have Medicare, read thisAs of February 2023 Medicare only covers nutrition therapy with a physician referral for a diagnosis of diabetes (cannot be pre-DM) or CKD (chronic kidney disease, stage 4-5, NOT on dialysis). If you have one of those, let’s get to work! If not, there are still options! Please see the FAQ dropdown “what if you do not participate with my insurance provider” to learn more.
What insurance providers are you in-network with?We are currently in-network with Cigna, Aetna, BCBS FEP, CareFirst BCBS, and Medicare. If we do not participate with your insurance plan (out-of-network), we can provide you with a super-bill that you can submit to your insurance plan for reimbursement or applied towards your deductible.
Are visits conducted in person or virtually?At this time, all visits are conducted virtually via a HIPAA compliant platform. Currently, most insurances are covering for telehealth services. Therefore, when you schedule your visit you will be directed towards the next steps to setting up properly for your telehealth session. However, it is possible your insurance plan may impose a cost-share for you to use this service. Therefore, please call your insurance company to confirm your telehealth coverage PRIOR to scheduling your visit.
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