Insurance

Our Job:

Our billing team will verifying your benefits prior to the first session. We don’t want any surprises (for you or us!). We call the “Provider” phone number on the back of your insurance card.

The associates at On the Brink Nutrition Collective are in-network with most Aetna and United Healthcare plans.

For us to verify benefits for outpatient nutrition counseling, you'll need to provide us with three things:

  1. a photo or screenshot of the front and back of your insurance card

  2. your date of birth

  3. documentation of a specific ICD-10 code(s) from your doctor that we can use to submit a claim. Registered Dietitians are not able to diagnose medical or mental health conditions - that’s the doctor or therapist job. Here is a list of common medical and mental health diagnosis codes covered by insurance. You can...

    • Have your doctor's office fax us just your ICD-10 diagnosis list or a referral that includes the code(s). Our fax number is 480-933-0036.

    • You may be able to log in to your doctor's patient portal and access the codes yourself. If so, take a screenshot. Be sure whatever you give us clearly shows both your name and the code(s).

    • Diagnosis codes are often printed on the Explanation of Benefits (EOB) statements provided to you by your insurance company following your medical appointments. If so, you can email us an EOB from a doctor's visit.

Email this information to our secure email: insurance@onthebrinknutrition.com

If you are unable to provide us with a specific diagnostic code, there’s a work around. We will use “Z71.3 Dietary counseling and surveillance” to check the benefits. This is the only ICD10 code Registered Dietitians can use without the oversight of a doctor or therapist.

We are out of network with other insurance companies. We can provide you with a “superbill” which you can use to submit to your insurance company for reimbursement. Not all insurance plans reimburse for services provided by out-of-network providers. You’ll need to call your insurance company to inquire about your out-of-network benefits (see the next section for instructions on how to do this). If we are out-of-network with your insurance company, you will need to pay for your sessions at the time of service (the Cash Pay Rate of $130/50 minute session). After you submit the superbill to your insurance company, the reimbursement will be paid directly to you from your insurance company.

Your Job:

We want to help prevent surprises when it comes to the cost of working with our group.

If you hope to use your insurance plan to cover all or a portion of your nutrition therapy, it is important that you understand your coverage, including your co-pays, co-insurance, and deductible. Even though our team verifies benefits, it can be helpful for you to cross-check the information provided to our biller from the “provider side” of your insurance. To do so, contact your insurance company prior to your first visit. Plan for 30 minutes as hold times can be long. This is a great task to do while you are doing light house work, watching your favorite show, or feeling particularly at peace with the world.

Call the “Member Line” on the back of your insurance card (aka “Customer Service” telephone number).

WHEN CALLING YOUR INSURANCE COMPANY, ASK THE FOLLOWING QUESTIONS TO HELP DETERMINE YOUR COVERAGE: 

I’m calling to check to see if my plan covers outpatient nutrition counseling.

Are the Registered Dietitian Nutritionists at On the Brink Nutrition currently considered in-network providers for my group plan? 

  • Liz BrinkmanNPI number 1750681284

  • Megan Taylor: NPI number 1801522834

  • Allison Cain: NPI number 1811624828

If not, what are my out-of-network benefits? How do I submit a superbill for reimbursement?

Does my plan cover outpatient nutrition counseling using the CPT codes 97802 (Medical nutrition therapy; initial assessment and intervention) and 97803 (Medical nutrition therapy; re-assessment and intervention)? *CPT codes describe the services provided.

Here is the important part: You will get the most accurate coverage information when you ask about the CPT codes (service provided) combined with the ICD10 code (diagnosis code)

Does my plan cover outpatient nutrition counseling using the following combination of procedure codes (CPT) and ICD10 codes (diagnosis codes):

ICD-10 code z71.3 Dietary counseling and surveillance when billed with the CPT codes 97802 and 97803? 

  • Does this combination of codes qualify under the preventative care portion of my plan? (If so, oftentimes the deductible does not apply and there is no co-payment or co-insurance. That means no cost to you!).

  • Does this combination of codes qualify under the cost-share portion of my plan? What is my financial responsibility (copay, deductible, co-insurance)?

ICD10 codes provided by your doctor or therapist, such as an Eating disorder diagnosis or diabetes when billed with CPT codes 97802 and 97803?

  • Does this combination of codes qualify under the preventative care portion of my plan?

  • Does this combination of codes qualify under the cost-share portion of my plan? What is my financial responsibility (copay, deductible, co-insurance)?

Do I need a referral from a primary care doctor or therapist? 

Do I need a pre-authorization?

How many sessions are covered per year?

What month does my policy year renew?  

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

Does my plan cover telehealth/virtual visits for Outpatient Nutrition Counseling Services?

Please write down the name of the representative you spoke with along with the date and reference number for your call.

Finally, email the answer to these questions to insurance@onthebrinknutrition.com. Note that we will not accurately know how much insurance will pay until we have filed the claim and it has been processed. If the claim is denied, you will be responsible for the cash-pay fee of $130/visit.