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.

Additional Questions

Who do you work with?

All kinds! We offer care to women, men, and folx of all ages. We also work with teens, children, and families. Our practice is LGBT-Q affirming.

Our clients deal with a wide range of food and movement challenges and many have not been diagnosed with an eating disorder. However, most are experiencing some sort of discomfort when it comes to their “relationship” with food and their bodies. Whether you’re dealing with an eating disorder, GI issue, family feeding challenge, diabetes, etc… we always incorporate mindfulness and intuitive eating principles, as appropriate.

Where are you located?

We now have two office locations (addresses can be found on our homepage). Kelsey primarily practices in our Sorrento Mesa office and Lindsay and Maddie primarily practice in our Rancho Bernardo office. Our office locations are easily accessible from the following areas: Sorrento Valley, Sorrento Mesa, Mira Mesa, La Jolla, UTC, Encinitas, Del Mar, Carmel Valley, Rancho Santa Fe, 4S Ranch, Del Sur, Rancho Bernardo, Rancho Penasquitos, Poway, Scripps Ranch and more!

What exactly is intuitive eating?

Intuitive eating is a unique, non-diet approach to wellness and one that we use extensively in practice – in many different ways. Many people understand it as an approach that focuses on using our own internal hunger and fullness cues to guide our eating choices. While that is a core tenant of intuitive eating, it’s important to know that this approach extends far beyond hunger and fullness cues. When you work with someone who is truly trained in this approach you will extensively explore what food and movement means to you. In our sessions we will sort through your food beliefs, self-talk, food behaviors, etc… to get to the bottom of why you do what you do when it comes to eating and moving. The real, central focus is always self-care and this looks different for every body. Using a counseling technique called motivational interviewing, we will help guide you towards your unique wellness by helping you reach a place of self-care and health that works for you – lifelong.

Will I lose weight? It seems like you think weight loss is a bad thing.

Intuitive eating is a non-diet, weight neutral approach. We work with clients to heal their relationship with food and their bodies and guide them in shifting the focus from weight loss to wellness. Some clients lose weight, some gain and some don’t notice much of a change at all. We will support you in reducing the focus on weight and discuss that challenges that you face when working to separate your weight from your health.

We don’t think weight loss is bad but we do see the intense harm that the pursuit of weight loss can bring. Weight changes that occur as a result of healing are very different than the pursuit of weight loss through “wellness” behaviors that actually manipulate the body and wreak havoc on your emotional well-being. Weight-loss is not a behavior; rather it’s an outcome. We believe that, for the majority of individuals, focusing on weight-loss impedes on our ability to confidently respond to our body’s needs and ultimately moves us further away from wellness and self-trust. For example, let’s say you decide you’d like to start getting outside and taking a nice walk on your lunch break. Sounds lovely! You make this decision because you would like to lose weight. As you begin this new walking routine you begin to monitor your weight change and notice that your weight is not changing in the way you expected it would. Let’s say you become frustrated with this fact and decide to stop walking all together. If it’s not “working,” what’s the point? Unfortunately, using weight change as an indicator of wellness and the perceived benefit of movement has ultimately caused you to decrease what may have been a supportive way to move your body. You may miss out on knowing whether or not you actually enjoy walking and if it feels good to you. If we were to take weight out of the equation and focus on other perceived benefits of exercise we may point out that you noticed better performance in the afternoon at work, a decrease in stress and an increase in energy. When we can be present enough to notice these side effects of self-care and make wellness choices that work for US (not the scale), we can be much more likely to seek movement and a relationship with food that truly feels supportive to us.

Will we talk about healthy eating?

Absolutely! Many of our clients feel so inundated with messages about nutrition and healthy eating that they aren’t even sure what it means anymore. Often times, they feel paralyzed when it comes to making choices for themselves and their families. We’ll start that conversation by taking a close look at what healthy eating currently means to you and what you hope you’re eating will look like after we work together. During our work together, we will likely look at expectations you have for yourself when you make a food decision, explore the common categorization of “good” and “bad” foods, look at how food impacts your mood, energy levels, ability to focus, etc…, just to name a few. Often times there are some other aspects of your eating that will need to be addressed before we can discuss nutrition in a neutral way without the diet mentality taking it and using it in a negative way. This will be something we discuss and assess when we meet.

Do you offer groups?

Yes, periodically, we will host groups such as my Postpartum Body Image and Nutrition Support Group, Prenatal Self-Care Class, Diet Rehab Workshops or Child Feeding Coaching series. If you’re interested in one of our groups sign up here to get news on new groups and discounts. You’re also encouraged to recommend or request that we host a group! We’ll hold a group for 3 or more individuals so if you have a group of friends who would like a special, private group, we’re happy to work with you on scheduling this. Also, the individual who initiates the group gets a discount!

I see you’re an advocate for intuitive eating. I’m dealing with an eating disorder and I don’t think I’m ready for that. I’m not even sure I want my recovery to include intuitive eating. Are you ok with that?

I’m so glad you asked this question! First, I always discuss what vision my clients have for recovery. This is an important part of the recovery process. It’s also an ongoing conversation of which the outcome is constantly changing. If you don’t feel intuitive eating is where you’d like to head in your recovery, we absolutely will discuss what you do envision instead. If we’re mainly looking at intuitive eating as just listening to your hunger and fullness, there are many instances where that would not be appropriate in eating disorder recovery. There are complex brain processes that can inhibit one’s ability to do so, especially in early stages of ED treatment. As the body and brain heal, many will begin to identify cues of various degrees and we can work very thoughtfully on how to respond in a way that feels safe. We spend many sessions discussing your cognitive, physical and emotional reactions to these cues, fears you may have about their return and how to respond, factors that impact the senses of hunger and fullness, etc…

Our family has been using Family Based Therapy (FBT/Maudsley). Do you know what that is and can you continue to help us with feeding our child?

We are very familiar with FBT. Traditionally, dietitians are not used in FBT so, depending on where you received treatment, you may not have worked much with a dietitian. We share one of the core beliefs of FBT, which is that parents should be part of the treatment process and that they are the experts in their child. We do believe parents should play a very active role in their child’s recovery. As a dietitian, we can be a support person for you during this process. Re-feeding a child with an eating disorder can be scary, draining, stressful, confusing and emotional. We am here to encourage, reassure and provide education as needed as you move through the stages of FBT with your child. We can also work with your family to help transition your child back to his or her role as an active participant in his or her self-care as the responsibility of self-feeding is re-introduced. This is a critical point in this process. In addition, it’s important that teens don’t transition to college before working directly with a dietitian who can support them with essential life skills of grocery shopping, cooking, feeding, etc…, ways of resisting and challenging food and body image triggers, etc… Since each family is unique, the plans for treating teenagers will vary. You can read more about our approach to working with teens with eating disorders here.

Are you familiar with Dialectical Behavioral Therapy (DBT)?

Yes! Our team has training in DBT and have worked on teams that use DBT in higher levels of care. We can use methods that compliment DBT skills and coping tools that you are using in therapy.

Will you give me a meal plan?

Yes, if you’re working on eating disorder recovery, you will likely have some sort of a meal plan as part of your treatment. In our process, meal plans are highly individualized and very carefully constructed with your full participation. Some clients need very clear, structured plans and others need more loose guidelines. We may spend several sessions collecting information before constructing the right plan for you or we might start a plan at your first appointment. We always encourage you to share what you think you need and what feels the most supportive.

I need someone to tell me what to do? Can you do that?

We expect you to be an active participant in the recovery process. We are a team. We are not authoritarian (controling, demanding) figures in the working relationship. Rather, we see ourselves as supporters, advocates, educators, and cheerleaders. We’re 100% invested in your treatment and we expect you to also be 100% invested. That looks different for everyone depending on your stage in recovery. Being ambivalent (unsure) about your recovery from time to time is part of the recovery process and we’re here for you on your recovery-minded days as well as your entrenched-ED days. On a rough day or week, just showing up for a session tells us you are invested. Some clients need more direct recommendations than others and this will be assessed on an ongoing basis. If you are looking for a dietitian who does take on a more authoritarian position and spends the majority of the session instructing (rather than listening and encouraging you to be an active participant), we are not the team for you.

Will I be working with just one dietitian on your team or will this change throughout my treatment?

You will be assigned to a dietitian on the team and that is who you will carry out your treatment with.