Verifying Your Insurance Benefits

If you plan to use insurance, you must call your insurance company to verify your benefits before your appointment. While I am in network with the companies noted above, each insurance policy is unique, which is why it is important to verify nutrition counseling benefits PRIOR to your appointment. If insurance declines to cover your visit(s) for any reason, you are responsible for the full amount billed.

Note: I currently do not accept Medicare or Medicaid plans.

To verify your benefits, call your insurance company and ask:

• Is nutrition counseling covered on my insurance plan?
  • The procedure codes used are 97802 for initial appointments and 97803 for follow up appointments
• Are there restrictions regarding which diagnoses are covered? Does my plan cover either z71.3 or z72.4 (dietary counseling and surveillance) or is a medical diagnosis required?
  • Your plan may cover preventative care using the code z71.3 (dietary counseling and surveillance) OR your plan may require a medical diagnosis.
  • If a medical diagnosis is required for coverage, have your doctor fax recent visit notes and your diagnosis to me at 855-615-2920.
• Do I need a referral or prior authorization?
• How many visits are allowed per calendar year?
• Have I met my deductible? If not, is the deductible waived for preventive nutrition therapy?
  • If you have not met your deductible and it is not waived for preventative care, you will be charged the standard fee noted above, which will apply to your insurance deductible.
• Do I have a co-pay or co-insurance for nutrition counseling?
  • For most insurance companies I am considered a specialist. Therefore, your specialist co-pay would be applicable. I generally wait for the claim to be processed and then charge the credit card you have on file the co-pay amount. 
• Is nutrition counseling covered when provided via telehealth?
• Is Jennifer Melanson Nutrition (NPI 1245820976) covered under my plan? If not, what are my out-of network nutrition benefits?
• Write down the date and reference number for your call.

Out of Network Reimbursement

If you have out of network coverage for nutrition counseling with another insurance provider, I can provide you with an itemized invoice (“Superbill”) so that you can seek reimbursement from your insurance company. If you are unsure about your coverage, call your insurance company and asking if they cover the following CPT codes out of network: 97802 (initial nutrition appointment) and 97803 (follow-up nutrition appointment). If you have a diagnosis from your physician, you may need to provide your medical diagnosis code (ICD-10 code). 

Questions?

If you have additional questions, please visit the FAQ or schedule a complimentary 15 min phone call.