Insurance Help

When calling your insurance company, ask the following questions to help determine your coverage:

1. What are my out of network benefits?

2. Does my plan cover outpatient nutrition counseling, CPT codes 97802 (nutrition assessment), 97803 (follow up), or 97904 (group)? If you have diabetes, you may also want to ask about diabetes management codes, G0108 (individual) and G0109 (group).

3. Do I have any nutrition counseling visits covered under the preventative care portion of my plan, (ICD-10 code z71.3)?

4. Do I need a physician referral?

5. Do I have a deductible for “Nutritional Counseling Services”?

6. If yes, how much is it and how much has been met so far?

7. Is there a copayment for each visit or do I have co-insurance? If I have co-insurance, what is the percentage of coverage?

8. How many sessions are covered per year?

9. What month does the policy year renew?

10. Are there any restrictions and/or limitations to my coverage?

Feel free to contact us if you have questions about working with your insurance company.