Get treatment for all your nutritional healthcare needs.
Insurance Coverages
Insurances
Proper Nutrition Therapy is In Network with most of the large commercial insurances such as:
Aetna
Highmark Blue Cross Blue Shield
Cigna
Medicare
Independence Blue Cross
United Healthcare (in progress)
* Most of these insurances have coverage for nutrition counseling.
Coverage varies greatly between plans. Each client is responsible for checking with their insurance company (if you are worried about it being covered), we do not check benefits. Please scroll down for information about how to check with your insurance company to determine what your plan covers. If insurance declines to cover your visit(s) for any reason, you are responsible for the full amount billed.
Verify Your Insurance Coverage
Before your visit, please call your insurance company.
You will need to determine if medical nutrition therapy (MNT) is covered by your health insurance plan. If your insurance company is listed above that means we are in network with your plan. We are happy to submit claims for your visits, however you should be aware benefits can vary greatly by plans. It is important to verify your coverage to help ensure you get the most out of your benefits and avoid financial surprises!
· Call the member services number on the back of your insurance card.
· Our official business name is Proper Nutrition Therapy LLC. Tax ID: 99-3010894
· Dietitian or Provider is Rachel McGuinness NPI #: 1205496056
Here are some important questions to ask:
1. Does my plan cover medical nutrition therapy (CPT code 97802, 97803)?
If yes, am I covered under both my preventative and medical services?
Preventative _____________ Medical ______________
2. Do you cover the preventative diagnosis code Z71.3? If not then what codes are covered? BMI codes? Overweight? Obesity? Get the specific codes.
3. Are there any limitations? How many visits covered? __________ Telehealth coverage? _________
4. Are my visits subject to:
my deductible? __________
a copay? __________
or coinsurance? __________
(Most preventative benefits do not go towards deductibles, coinsurance or copays, however if your policy dictates a dietitian is a specialist there could be an applicable copay. We will submit the claim and invoice you with any patient responsibility if needed.)
5. Do I need a physician referral? (All HMO plans require a physician referral for nutrition therapy and will need to be provided before the initial visit)
6. Do I need preauthorization? If yes, your primary care physician will need to do this. Dietitians are not able to request prior authorization with insurance.
Please ask for a reference number and date from your phone call.
Note: If you need a physician referral, please call your doctor and have the office staff fax over a referral with the correct diagnosis code to Fax number (267-762-4432).