Insurance Verification Worksheet

Insurance Verification Worksheet

Script for Verifying your Insurance

CareFirst logo
Cigna logo
UHC logo
Aetna
EHP logo

If your insurance company is found in the above list, this means we are participating with your plan. 

We are happy to submit the claims for your visits; however you should be aware that benefits for nutritional counseling can vary greatly among individuals. Not all policies contain benefits for nutritional counseling. 

Here you will find a worksheet that will help you navigate the insurance verification process.

When calling your insurance company be sure to tell them that you are seeing an in-network registered dietitian. 
Our NPI (national provider identification)  number is 1124495957.

  1. Do my benefits include nutritional counseling?_________
  2. If yes, am I covered under both my preventive and medical services? Preventive ____.  Medical____
  3. Are there any exclusions or limitations (such as limit to number of visits)? ______
  4. Are my visits subject to a deductible? If yes, has my deductible been met for the year?______
  5. Am I responsible for any copay or coinsurance for the visit?____________

We do not accept Medicaid or any managed Medicaid plans including:

  • Amerigroup
  • Priority Partners
  • Better Health
  • Community Plan
  • Jai Medical Systems
  • UMMS Health Partners

We also do not accept:

  • Kaiser Permanente
  • Tricare

Please be advised that Medicare only covers nutrition counseling if you have a diagnosis of diabetes or pre-dialysis kidney disease. They will not cover any other diagnosis even if you have a referral from your physician.

We do offer discounted self-pay rates for those paying out of pocket at the time of service.

Scheduling

Interested in setting up an appointment? We offer daytime and evening hours in multiple locations and online.