Using Insurance

Yes, for Dietitian (Medical Nutrition Therapy) visits!

We are in-network with some carriers:

• United Healthcare
• Aetna
• Cigna
• Anthem / Blue Cross Blue Shield

Important: We are not in-network with every plan under these carriers. To confirm coverage, ask your insurance if we are in-network using:

Practice Name: Essential Nutrition
Tax ID: 72-1619509
Group NPI: 1104043553
Individual Dietitian NPI: Please contact our office to obtain this

• Medicare
• Medicaid
• Humana
• Kaiser
• Tricare

If you have one of these, contact us; we can still discuss other options.

Your cost depends on your specific insurance plan. You may have:

• A copay (fixed fee per visit)
• A coinsurance (percentage of the visit cost)
• A deductible (amount you must pay before insurance starts covering visits)

Even if you have nutrition benefits, coverage is NOT guaranteed.

Before your appointment, call your insurance and ask:

• Do I have nutrition counseling benefits?
• Are these CPT codes covered?
  1. 97802 (initial visit)
  2. 97803 (follow-up visits)
• Do I need a medical diagnosis for coverage?
• Do I need a referral or prior authorization?
• Are there visit limits (how many sessions per year)?
• Is telehealth (virtual visits) covered, or in-person only?
• Do I have a deductible, and has it been met?

Some insurance plans only cover visits if you have a medical diagnosis (like diabetes, kidney disease, etc.).

If you have United, Aetna, or Cigna:

• Contact your doctor to get your diagnosis code(s) before your first visit
• This can improve your chances of coverage

• Insurance quotes over the phone from your carrier are not a guarantee of payment
• Coverage depends on:
  • Your specific plan
  • Diagnosis code used
  • Procedure code billed
  • Medical necessity

Claims can still be denied even if benefits were quoted!

Some plans:

• Only cover in-person visits (Boulder or Denver)
• Others allow telehealth (virtual visits)

Be sure to confirm this with your insurance.

If we are not in-network with your plan:

• You can still see us as a self-pay patient
• We can provide a superbill for you to submit for possible reimbursement

• We are not providers for Medicare or Medicaid
• We cannot bill these plans, even if they are through another insurer (like United)

Contact us to discuss alternative options.

• Coaching services are self-pay only (out-of-network)
• Contact us for pricing, programs, and memberships
• Get the help you need without insurance directing care or dictating how much care you can receive!