Checking Insurance Benefits
Checking In-Network Benefits
Meredith Price, MS, RD, CDN is in network with most Aetna, Empire Blue Cross Blue Shield & United Healthcare plans.
Follow the steps below to check your insurance benefits to find out if nutrition counseling is covered by your plan.
Note: Record the representative’s name and a reference number when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.
1. Call the member services number on the back of your card and ask:
“Does my plan cover outpatient nutrition counseling sessions?”
Provide the representative with the following CPT codes: 97802 (initial session) and 97803 (follow-up sessions).
If the answer to this question is no, then you will be responsible for the full cost of the nutrition counseling session.
2. If the answer to #1 is yes, then ask the following questions:
Is Meredith Price, NPI # 1063948511, a provider in my network?
Do I have a deductible to meet first? If yes - how much is left?
Do I have a co-pay for outpatient nutrition counseling?
Do I need a physician referral for outpatient nutrition counseling?
How many sessions per calendar year are covered?
3. What is covered?
For Aetna patients: Is Z72.4 covered for preventative health?
For BCBS and UHC patients: Is Z71.3 covered for preventative health?
For all plans: If you have any other conditions that are nutritionally relevant such as high cholesterol, high blood pressure, diabetes, IBS, weight management, etc you can ask if these conditions are covered as well. Some Aetna plans cover family history of diabetes and heart disease as a preventative measure.
Do I have telehealth coverage for virtual visits during the COVID-19 crisis and if so, until what date?
Don’t forget: Record the representative’s name and a reference number when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.
Ready to Get Started?
Checking Out Of Network Insurance Benefits
Don’t have Aetna or BCBS? You may have “out of network benefits” with your insurance plan. If you do, Meredith Price can provide you with a receipt, known as a Superbill, to submit to your insurance for potential reimbursement after you pay the full cost of the session.
To find out if you qualify, call the member services number on the back of your health insurance card and ask the following questions:
Does my plan cover out-of-network services? If the answer to #1 is yes, proceed.
Does my plan cover nutrition counseling ? If so, how many sessions does my plan cover per year? **If needed: CPT codes 97802 and 97803; Diagnostic code Z71.3**
Do I need a referral from my PCP to go to a dietitian and get reimbursed for out-of-network outpatient nutrition counseling coverage?
Where and how can I submit a superbill for reimbursement?
Be sure to record the representative’s name and a reference number when checking your benefits. This information will be necessary if you ever need to dispute a rejected claim.
