Insurance FAQs

Please note that it is the patient’s responsibility to verify insurance coverage prior to scheduling. Confirming in advance helps prevent unexpected costs and ensures you understand any out-of-pocket expenses.

Many health insurance plans include benefits for nutrition counseling. Coverage varies by policy, so we encourage you to contact your insurance provider directly to confirm your specific benefits before your visit.

To verify coverage, call the member services number on the back of your insurance card and ask a representative about benefits for nutritional counseling. The information below will guide you through the questions to ask and the details to confirm.

Current insurance plans that I accept
Currently, I’m in network with Aetna, Blue Cross Blue Shield, and UnitedHealthcare.
 
However, you will need to confirm that your specific insurance plan has nutrition coverage. Therefore, you are required to call your insurance company prior to scheduling your visit to confirm that your nutrition visits will be covered.
  • Do I have coverage for nutrition counseling?
  • Do I need a referral to see a Registered Dietitian?
  • Are my diagnoses covered on my particular plan?
  • How many visits per calendar year do I receive?
  • Do I have a cost-share for these services?
  • Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus in person visit?

If the insurance company asks for a CPT code please provide them with the following codes 97802 & 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. We also can bill for S9470 if it is covered on your policy. 

  • If the representative asks for a diagnosis code (aka ICD 10 code) – please tell them the visit is coded the ICD 10 code: Z71.3
  • If they don’t accept Z71.3 then provide them with Z72.4 and see if they will cover that diagnosis instead on your plan. 
  • 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.
  • We always code your visit using preventative coding (if applicable) to maximize the number of visits you receive from your insurance carrier. However, if you ONLY have a medical diagnosis (for example: IBS, and you are not overweight or have CVD risk factors) your insurance may impose a cost-share for your visit either in the form of a deductible, co-pay or co-insurance. 

Your carrier will let you know how many visits they are willing to cover. Depending on the carrier the number of visits varies from 0 to unlimited depending on medical need.

  • The cost-share is the amount you will need to pay as required by your particular insurance plan towards your services. A cost-share can be in the form of a deductible, co-pay or co-insurance. 
  • We will always bill under your insurance policy’s plan under your preventative benefits if your plan allows. If you have preventative benefits there if often NO cost share for you associated with the visit. Once again, this is something YOU do want to ask prior to your visit. 
  • In the event you have a cost-share we will initially bill your insurance company directly.  Once we receive the EOB describing your responsibility as the patient, we will bill the credit card on file for the amount noted under ‘patient responsibility.
  • For most insurance companies dietitians are considered specialists. Therefore, your specialist co-pay is applicable and is payable at the time of service. This information is often apparent on the front of your actual insurance card. However, often because we bill your insurance with preventative counseling the co-pay is often not applicable.
  • We generally wait for the claim to be processed to determine whether you have a co-pay and then charge the credit card you have on file with us the co-pay amount. 

Most insurances are still covering 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. Please call your insurance company to confirm your telehealth coverage PRIOR to scheduling your visit. Although, if you prefer to be in-person at our South Windsor or Manchester, CT location we are happy to accommodate your request. 

Arizona, California, Colorado, Connecticut, Massachusetts, Michigan, New Jersey, New York, Oregon, Texas, Virginia, Wisconsin

However, you will need to confirm that your specific insurance plan has nutrition coverage. Therefore, you are required to call your insurance company prior to scheduling your visit to confirm your nutrition visits will be covered.

 

Please follow the steps below ‘What questions should I ask when calling my insurance?’

 

In the event, your claim is denied for lack of nutrition coverage our initial visits (60-minutes) are $200.00 and each follow-up visit (30- 45 minutes) is $100.00. Healing Heart Nutrition LLC accepts HSA/FSA cards and all major credit cards, cash and check.