What About Insurance?
Beyond The Plate Nutrition and Wellness does not accept insurance directly, but can provide a superbill for out-of-network reimbursement.
*Please check and see if you have telehealth benefits in addition to Medical Nutrition Therapy (MNT) benefits. Things are rapidly changing due to COVID-19 and some insurance companies are changing policies.*
We recommend you contact your insurance company to see what benefits your plan may have regarding Medical Nutrition Therapy (MNT) coverage. Please specify this is for telehealth, as Beyond The Plate Nutrition and Wellness is a virtual private practice.
Call the phone number for customer service - usually located on the back of your insurance card. Ask if Medical Nutrition Therapy (MNT) is a covered benefit based upon your plan and diagnosis. You will want to ask exactly what they will cover in terms of diagnosis, number of visits, and what they will pay after you reach your deductible. If your insurance company says that Medical Nutrition Therapy (MNT) is a benefit, be sure to document the date and who you spoke with and ask them to send you the information in writing.
The procedure codes we use for Medical Nutrition Therapy (MNT) are: 97802 (initial assessment) and 97803 (follow-up assessment). The diagnosis code used will depend on your situation.
After each visit, we will provide you with a superbill receipt if requested. We can also provide this on a monthly basis if it’s easier for you. You can submit this receipt with a CMS1500 form (or whatever form your insurance company requests) to try to receive out-of-network reimbursement. Do NOT sign over payment to us as the provider.
We recommend keeping track of your visits and submissions with the insurance company in order to keep your reimbursement organized.
Further Questions
What if my insurance company says they cannot tell me if a certain diagnosis is covered?
Sometimes insurance companies say that they are unable to provide details about medical nutrition therapy (MNT) for certain diagnosis codes. As a member of the insurance company plan, you have a right to know your coverage. Demand to see the specific policy re: MNT and it should be included.
What if my insurance company says that they will only cover diabetes (or another condition you are not seeking care for)?
Unfortunately, this would be a situation where you would probably not receive out-of-network reimbursement. You can request to know what other diagnosis they may cover (such as General Dietary Counseling, a certain BMI, etc) and if it’s applicable to your situation and we have confirmation from your physician, we can code it on your superbill.
If Beyond The Plate Nutrition and Wellness receives payment for services, can you cash the check over to me as the client or credit my account?
If we receive a check, benefits card, or any other form of payment, we will not cash it or attempt to collect the money in any way. We will notify you immediately if we receive anything and will scan our communication to you directly. It is up to you to call your insurance company to explain the mix-up. Because this happens occasionally, we have a recommended process for you to follow. What we usually receive is called an EOB (explanation of benefits). You can usually log into your account and see any claims and how they were handled as well. We recommend that you check your account too to see what information is available on the "member backend".
The insurance company is absolutely responsible for canceling (or putting a stop payment) on any check if it went to the incorrect person. After they put a stop payment on the check, they should be able to re-issue it to you as the member. Always collect a reference number and demand to speak to a supervisor if it’s not resolved in a timely manner.
What if my insurance company goes against what they initially told me (for example, they said they would cover a visit and then only partially reimbursed me)?
We always recommend getting a reference number every time you speak to your insurance company about coverage. We are unable to provide full or partial refunds.
How do you handle insurance disputes?
We leave all insurance disputes to our clients. We are so sorry for any inconvenience caused by an insurance dispute.