Insurance & Fees
How much does it cost to work with you?
Fees vary based on the RD you are working with or the type of appointment you’re scheduling.
Initial assessment
$250
50-55 min follow up
$165 – 225 depending on provider
Rates increase for family work and for longer sessions.
You can pay with cash, check or card. A card is required to be on file.
We don’t offer a traditional “sliding scale” but we do keep a couple of spots available for those who need help financially. Contact us to receive information.
Insurance
In-Network
We are currently in-network with Health Net. Coverage and benefits may vary based on your diagnosis and specific plan. We ask that you contact your insurance company to check your benefits. There are often costs associated with using insurance (co-pays, coinsurance, limited visits) and you, the client, will be responsible for those fees. Regardless of coverage, we require a credit card to be kept on file. Use the instructions below to check your benefits.
Health Net PPO Plans
It’s likely that you do not need prior authorization to schedule with us. Please double check with you check your benefits with Health Net. You will still need a referral from your physician or therapist with a diagnosis to be kept on file. When you reach out to schedule, we can send you our practice referral form. It’s also ok for your physician to write a referral on their own form. If you don’t have a nutrition-related diagnosis we have other options and can discuss them when we meet.
Health Net HMO Plans
You will likely need a referral and prior authorization before scheduling with us. When you check your benefits, ask about whether your PCP needs to submit prior authorization to your medical group. It’s likely this is the case. Your physician will need information about our practice. You can provide that to them with our practice referral form or send them to www.nutritioninstincts.com/refer. Note: We DO take Health Net Blue and Gold plans that UCSD provides employees! Your physician may not be familiar with referring to us but they can! We’re in the “Direct Network Specialists” group and can be referred to as in-network.
Instructions for Checking In-Network Benefits
Office information you might need:
Business is: Nutrition Instincts, Inc
EIN: 87-4625701
NPI for Lindsay: 1902126360
NPI for Maddie: 1164087573
NPI for Andrea: 1821606344
1. Call the phone number for customer service which is usually located on the back of your insurance card. If your employer provides your plan, your HR department may be able to call on your behalf.
2. You’ll want to speak to the benefits department. Ask if Medical Nutrition Therapy (MNT) is a covered in-network benefit based on your plan. The procedure codes we use for MNT are: 97802 (initial assessment), 97803 (follow up), 97804 (group) and occasionally S9470 (nutrition counseling code). Ask them if coverage is dependent on your diagnosis. Provide them with your nutrition-related diagnosis. You may want to ask if there are any benefits for “preventative Z codes” such as Z71.3. If so, ask which Z codes and what the requirements are.
3. If there is an MNT benefit, ask if there are any restrictions. For example, a limit of visits, having to use a certain practitioner, etc… Ask if your benefits are subject to copay, deductible, coinsurance, out-of-pocket max, etc… If your insurance company says that MNT is a benefit, be sure to document the date, every detail of information from the call, a reference number, and who you spoke with. If possible, ask them to send you the information in writing. Make sure that our practice will be covered.
Out-Of-Network
We can offer you a superbill that you can submit to your insurance in hopes of getting reimbursed. It is your responsibility to inquire with your insurance company regarding benefits and submit superbills (we can provide you with instructions when you schedule). The session fee must be paid to Nutrition Instincts, LLC at the time of service.
We are considered out-of-network with most PPO plans. We will provide you with instructions on how to inquire with your insurance company about medical nutrition therapy benefits when you schedule.
There is a company called Reimbursify that is available to assist with submitting superbills and obtaining reimbursement. Submitting claims can be a cumbersome process so Reimbursify is able to take that task off of your hands (for a fee). We are not affiliated with Reimbursify or their policies and receive no compensation for mentioning their service. We’re simply making sure potential clients are aware of this option. All clients seeing us out-of-network are required to provide our full fee at the time of service regardless of intentions to submit a superbill for reimbursement.
Blue Shield of California
We are officially listed as out-of-networked preferred providers with Blue Shield of California. This means you may be able to get some level of reimbursement if you have a PPO OR HMO (this is unique because HMO’s typically do not have out-of-network benefits). If you have an HMO, you’ll likely need a prior authorization with your referral from your physician. Contact the benefits department at Blue Shield to inquire about benefits, rate of reimbursement, and what you’ll need to obtain reimbursement.
Instructions on Checking Out-of-Network Benefits
Office information you might need:
Business is: Nutrition Instincts, Inc
EIN: 87-4625701
NPI for Lindsay: 1902126360
NPI for Maddie: 1164087573
NPI for Andrea: 1821606344
1. Call the phone number for customer service which is usually located on the back of your insurance card. If your employer provides your plan, your HR department may be able to call on your behalf.
2. You’ll want to speak to the benefits department. Ask if Medical Nutrition Therapy (MNT) is a covered out-of-network benefit based for your plan. The procedure codes we use for MNT are: 97802 (initial assessment), 97803 (follow up), 97804 (group) and occasionally S9470 (nutrition counseling code). As them if coverage is dependent on your diagnosis. You may want ask if there are any benefits for “preventative Z codes.” If so, ask which Z codes and what the requirements are.
3. If there is an MNT benefit, ask if there are any restrictions. For example, a limit of visits, having to use a certain practitioner, etc. Ask if your benefits are subject to your deductible, coinsurance, out-of-pocket max, etc… If your insurance company says that MNT is a benefit, be sure to document the date, every detail of information from the call, a reference number and who you spoke with. Ask them to send you the information in writing. Make sure that our practice will be covered.
4. You may be able to have the MNT benefits applied to the “in network” benefit side of your insurance plan if they do not have registered dietitian in their network or if you have an eating disorder and they do not have a registered dietitian who is a Certified Eating Disorder Dietitian (CEDRD). When insurance companies agree to cover an out of network practitioner under the “in-network” benefits, this is often called Gap coverage. You may also be able to request a single case agreement for MNT depending upon your plan and diagnosis. Should you obtain a single case agreement or GAP coverage, we will require written documentation and information on copay, deductibles and how the insurance company would like to be billed for services.