Insurance

Currently, Brandi participates with BCBS, Aetna and Cigna. So, if your benefits cover nutrition services, you can use your insurance. However, that does not mean all individual insurance plans cover nutrition. Therefore, you are required to call your insurance company prior to scheduling your visit to confirm your nutrition visits will be covered. Please follow the steps below under the tab “What questions should I ask when calling my insurance?”

Brandi does not participate with United Health Care or any of its subprograms. If this is your insurance carrier, you will be required to pay for services out of pocket. I can prepare a superbill outlining your services and the payments made. This superbill can then be submitted to United for reimbursement.

In the event a claim is denied for lack of nutrition coverage my initial visits (75 minutes) are $150, and each follow-up visit (55 minutes) is $95.00. Brandi Wynne Nutrition accepts all major credit cards.

Please note, it is the client’s responsibility to call their insurance company prior to your visit to confirm coverage. I just don’t want any of my clients to have any surprise bills.

• If the insurance company asks for a CPT code, please provide them with the following codes 97802 & 97803. If they say you do not have coverage using those codes NEXT ask them to check your coverage for the following CPT codes: 99401, 99402, 99403 and 99404.

• If the representative asks for a diagnosis code (aka ICD 10 code) – please tell them the visit is coded the ICD 10 code: Z71.3
• If they don’t accept Z71.3 then provide them with Z72.4 and see if they will cover that diagnosis instead on your plan.
• If you are overweight, obese, have pre-diabetes, diabetes, hypertension, or high cholesterol you may want to see what your coverage is for these diagnoses as well.
• I always code your visit using preventative coding (if applicable) to maximize the number of visits you receive from your insurance carrier. However, if you ONLY have a medical diagnosis (for example: IBS, and you are not overweight or have CVD risk factors) your insurance may impose a cost-share for your visit either in the form of a deductible, co-pay or co-insurance.

• Your carrier will let you know how many visits they are willing to cover. Depending on the carrier the number of visits vary from 0 to unlimited depending on medical need.

• 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.
• I will always bill under your insurance policy’s plan, utilizing your preventative benefits, if your plan allows. If you have preventive benefits, there is often no cost share associated with the visit. Once again, this is something YOU do want to ask before your visit.
• If you have a cost-share, I will initially bill your insurance company directly.  Once we receive the EOB describing your responsibility as the client, I will bill the credit card on file for the amount noted under ‘patient responsibility’.
• For most insurance companies, licensed dietitian/nutritionists are considered a specialist. Therefore, your specialist co-pay is applicable and must be paid at the time of service. This information is often apparent on the front of your actual insurance card. However, often because we bill your insurance with preventative counseling the co-pay is often not applicable.
• We generally wait for the claim to be processed to determine whether you have a co-pay and then charge the credit card on file with us the co-pay amount.

• Do I have coverage for nutrition counseling?
• Do I need a referral to see a Licensed Dietitian Nutritionist?
• Are my diagnoses covered on my particular plan?
• How many visits per calendar year do I receive?
• Do I have a cost-share for these services?
• Is there an associated cost for me if I choose to have the appointment as a telehealth visit versus an in-person visit?