Insurance

In-Network Providers

We are IN-NETWORK providers with AETNA, ANTHEM BCBS, CIGNA, AMBETTER, HUMANA, MEDICARE, MERITAIN HEALTH, OSCAR COMMERCIAL, UHC, UMR.

Insurance Does cover Nutritional Visits

We do not verify benefits for our patients. For details on your coverage and plan options for nutritional counseling, please refer to the information below or contact the number on the back of your insurance card.

major insurance tag nutrition

Aetna Patients(Telehealth Accepted)

  • No referrals needed for nutritional counseling.

Ambetter Patients(Telehealth Accepted)

  • We are in network with Ambetter

Anthem/BCBS Patients(Telehealth Accepted)

  • Some Anthem HMO plans (e.g., Pathway X Guided Access. GAP PREFIX AND SOME R PREFIXES) require a referral to see a specialist.
  • Check your card for a PCP’s name/number and look for “referral required” on the back.
  • BCBS/Anthem covers healthy diet counseling 95% of the time.
  • BCBS Nebraska does not allow Nutrition Visit

Cigna Patients(Telehealth Acception Varies please give us call to confirm if your plan covers Telehealth)

  • Coverage depends on your plan:
    • 3 visits/year for nutritional counseling.
    • Unlimited visits for preventative medicine counseling.
  • HMO Connect Plan: We are out of network.

Humana Patients(Telehealth Accepted)

  • We are in network with Humana.

Medicare Patients(Telehealth Accepted)

  • Covered for:
    • Diabetes
    • Chronic kidney disease
  • Referral from a doctor is required. Please Fax a referral to 866-850-2765
  • Only the above conditions are covered; If you do not have one of the above conditions then self-pay applies.

Meritain Health(Telehealth Acception Varies please give us call to confirm if your plan covers Telehealth)

  • In-network with Meritain

 Oscar Patients(Telehealth Accepted)

  • In-network with Oscar Commercial plans.

United Healthcare Patients(Telehealth Acception Varies please give us call to confirm if your plan covers Telehealth)

  • Individual Exchange Plans: In-Network
  • State Health Benefit Plan: Requires a medical diagnosis such as obesity, diabetes, pre-diabetes, CKD, High Cholestrol, Hyperlipedemia etc..

 UMR(Telehealth Acception Varies please give us call to confirm if your plan covers Telehealth)

  • In-network with UMR

Out-of-Network Providers

  • If your Insurance provider isn’t listed, we’re out of network.
  • You can pay self-pay rates and request a Superbill for reimbursement.

Self-Pay Rates

👉 Please give us a call for more information about our Cash Pay Rates and Discount Packages.

Frequently Asked Questions for Insurance Company

What if the insurance company asks for a CPT code?

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.

What if I need continuous glucose monitoring?

We are now offering continous glucose monitoring at our office locations. Please verify with your insurance provider if the CPT code 95249 is a covered service.

Will my diagnosis be covered?

If the representative asks for a diagnosis code – please tell them the visit is coded the ICD 10 code: Z71.3 for medical nutrition therapy/ nutritional counseling. We always try to code your visit using preventative coding to maximize the number of visits you receive from your insurance carrier. Aetna also typcially has obesity prevention coverage on most plans.

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