Insurance Coverage
Wondering If Your Health Consultations Are Covered?
We are in network with many of the major insurance companies.
However, your plan may choose to cover specific or limited services for its members. It does not necessarily mean you will have coverage for nutrition therapy.
You are responsible for the cost of sessions if your insurance does not cover.
Please note: it is the patient’s responsibility to call their insurance company PRIOR to your visit to confirm coverage.
What questions should I ask when calling my insurance company?
Summary of questions to ask to verify your nutrition benefits:
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Do I have coverage for nutrition counseling?
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Do I need a referral to see a Registered Dietitian?
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Are my diagnoses covered on my particular plan?
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How many visits per calendar year do I receive?
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Do I have a cost-share for these services?
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Is Tiffany Champagne-Langabeer RDN or Sunrise Integrative Nutrition LLC considered in my network?
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Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus an in-person visit?
Do I have nutritional counseling coverage on my insurance plan?
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If the insurance company asks for a CPT code please provide them with the following codes 97802 & 97803.
Will my diagnosis be covered?
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If the representative asks for a diagnosis code (aka ICD 10 code) – please tell them the ICD 10 visit code will be Z71.3 Dietary counseling and surveillance.
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If you are considered overweight or have pre-diabetes, diabetes, hypertension, or high cholesterol, you may want to see what your coverage is for these diagnoses as well.
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We always code your visit using preventative coding as applicable to maximize the number of visits you receive from your insurance carrier. Medical nutrition therapy is one of the most cost-effective ways to improve overall health status and prevent chronic disease.
Do I need a referral to see a Registered Dietitian?
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If you have an HMO as listed on your card, the answer is Yes. If you participate in an HMO, I need to know this ahead of time to secure a referral from your physician.
How many visits do I have per calendar year?
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Your carrier will let you know how many visits they are willing to cover. Depending on the carrier, the number of visits varies from 0 to unlimited depending on medical need.
Do I have a cost-share for my nutrition visit?
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A cost-share is the amount you will need to pay as required by your insurance plan towards your services. A cost-share can be in the form of a deductible, co-pay, or co-insurance.
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For most insurance companies, dietitians are considered specialists. However, because we bill your insurance with preventative counseling, the co-pay is often not applicable.
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We generally wait for the claim to be processed to determine whether you have a co-pay and then charge the credit card you have on file with us the co-pay amount.
What if I am not in your network?
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You will be responsible for private pay rates, but you may be able to be reimbursed by your insurance.
Private pay methods
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Accepted payment methods include credit cards, Health Savings Account (HSA), and Flexible Spending Account (FSA). *HSA/FSA are pre-tax accounts that allow employees to set aside money to pay for qualified medical expenses.
Insurance Reimbursement
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If I am out of network, we can provide you with a superbill to submit to your insurance. Depending on your plan, they may reimburse you for the majority of the consultation. You will still be responsible for our private pay rates and will be charged at the time of service.