I am in network with Anthem (Blue Cross Blue Shield), Aetna, Cigna, UHC, and Oxford.

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In the land of insurance, we have two categories where we can bill:

"Preventative Health" and "Medical Nutritional Therapy". 

 

Preventative Health: Each provider has to offer their people "X" amount of preventative health sessions per calendar year. This usually means no copay, and you do not need to meet your deductible.  Each provider has different rules on preventative coverage.

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On average,e this is what each provider offers (this may be unique to your specific plan but here's an average of what I see)
 

Cigna: 3 sessions per calendar year. 

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Aetna: 10 sessions per calendar year. 

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Anthem: Unlimited (usually)

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UHC: 1 session per calendar year. 

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Oxford: 1 session per calendar year. 

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Once we use all of your preventative sessions, in order to continue coverage, it has to be medically necessary to bill under MNT.

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Medical Nutritional Therapy (MNT): In order to bill MNT it must be "medically necessary". Therefore, I will need a referral from your Dr (or anyone who can diagnose) stating that you are being referred to me for "X" medical diagnosis.  This could be - obesity, underweight, high cholesterol, high blood pressure, pre-diabetic, diabetic, etc. 

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Your Dr. can fax this referral to (203) 951-3511. 

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NOTE: I do not verify insurance benefits. If you would like to call your insurance ahead of time to see what is covered under your plan, you can do so by calling the 1-800 number on the back of your insurance card. I HIGHLY recommend you do this so there are no financial surprises. If I bill your insurance and the claim comes back denied, the patient is 100% responsible for the cost of the visit.

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Here are questions to ask: 

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1. Let them know that you are looking to work with me. They will likely ask you for my information.​ 

Company: Diehl Nutrition (Catherine Diehl) 

 

​Ask them:

 

1. Does my plan cover telehealth visits?

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2. Does my policy cover CPT codes 97802 and 97803?

 

3. How many preventative health sessions are covered per calendar year? Is ICD-10 code Z71.3 covered? 
 

4. How many medical nutritional therapy sessions are covered per calendar year? Do I have a copay? Do I need to meet my deductible before coverage?​

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NOTE: All testing (GI Map, Dutch, OMX, Trace Elements) comes from private labs. Therefore, we can not use your insurance to bill for labs. This is an out-of-pocket expense. However, I can submit a superbill to you for the cost of the test. You can then submit this to your insurance company as an "out-of-network" medical expense to see if they will reimburse you for the cost of the test. This can vary depending on your plan. I've seen people get back 20%, 30%, 50%, 100% - it really all depends on your specific plan. But, always worth a shot! 

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If your insurance gives you the green light (yay!!) then you can proceed and schedule your 60-minute initial consultation with me by clicking the link below. 

 

I look forward to helping you live your best life by living your healthiest life!