Leg Up Nutrition, LLC is in-network with Blue Cross Blue Shield of MA plans. This includes PPO, HMO, and Indemnity plans, and excludes Medicare Advantage plans. We understand that it can be confusing and frustrating trying to determine your insurance benefits. In an effort to make this process a little easier, we’ve created this script to help guide you in verifying your coverage.
IF YOU HAVE BLUE CROSS BLUE SHIELD INSURANCE: Please call the member services number on the back of your card and ask the insurance representative the following questions to verify coverage before booking your first appointment.
Does my plan cover outpatient nutrition counseling in a private practice setting? (Service / CPT codes we use are 97802 and 97803).
Does my plan cover telehealth?
How many visits with a dietitian do I qualify for each year?
If I do have nutrition benefits, does it only cover certain diagnoses?
Does my policy require a referral, pre-authorization, or pre-determination?
What is my co-payment or co-insurance due at each appointment for outpatient nutrition counseling?
Do I have a deductible, and if so, will the cost of my nutrition appointment be applied to my deductible? (The patient will be responsible for the cost of the session out-of-pocket.)
IF YOU HAVE A DIFFERENT PLAN: If you do not have Blue Cross Blue Shield, you may want to call your insurance provider to inquire about out-of-network reimbursement. Please call the member services number on the back of your card and ask the insurance representative the following questions to verify reimbursement.
Optional script: “Hello, I am interested in seeing an out-of-network registered dietitian. Does my plan provide reimbursement for out-of-network providers?” If yes, ask the following questions:
How many sessions does my plan cover, and how long are the sessions?
What is the deductible, and has it been met?
What is the coverage amount per outpatient session?
Do I need pre-authorization from my insurance company or PCP?
If you do have out-of-network coverage, you will be provided with a “Superbill” from your dietitian following the session. A Superbill is a detailed receipt of services that you paid for, which you can then submit to your insurance company for reimbursement by them. To assist you with this process, make sure to ask your insurance company exactly how to submit your Superbill for reimbursement. You can ask: “Where do I send the Superbill for reimbursement, and when can I expect to be reimbursed?”
Please note that Superbills are not a guarantee of reimbursement, and clients areresponsible for payment at the time of service.
HSA/FSA CARDS AND ACCOUNTS: If your insurance plan does not cover nutrition counseling but you do have a Health Savings Accounts or Flexible Spending Account (HSA/FSA) card, you can use that to pay for your sessions.