Eat Right Bucks County

Eat Right Bucks County’sguide for insurance reimbursement for medical nutrition therapy (Procedure Codes 97802/97803)

Eat Right Bucks County recommends all patients check their insurance plans

to confirm their individual plans’ coverage for nutrition counseling.

Insurances Accepted
Individual NPI # 1801169388/ Group NPI:1760728190

We will bill the patient’s insurance directly for the following plans:
(Patient does not need to pay upfront)

*Independence Blue Cross- Personal Choice

  • 6 visits per year - covered 100%
  • No co-pay
  • No Referral
  • No Diagnoses needed

*Keystone Health Plan East

  • 6 visits per year - covered 100%
  • No co-pay
  • No Referral
  • No Diagnoses needed

*Aetna

  • Generally 10 preventative visits and 26 obesity visits/calendar year
  • May have a co-pay after 10 visits
  • May require a referral
  • Patient needs to call and check insurance plan coverage.
    Some plans have high deductibles, but Nutrition Counseling is a covered preventative benefit and it does not apply to deductible amount. Other plans cover Nutrition Counseling, but only after deductible is met.
    (Please call your plan administrator to check your plan’s benefits or call Eat Right Bucks County with any questions
  • Visits not to exceed 1 hour.

*Amerihealth

  • 3 – 6 visits per calendar year
  • No co-pay
  • No referral

Insurance Plans we are in network with and accept. Patient Pays Up Front (cc, cash or check) at time of Visit.

Eat Right Bucks County requires the patient to pay up front for the below plans. Eat Right Bucks County will submit claim to the insurance company on patient’s behalf so no paperwork burden on the patient!! The insurance plan will reimburse the patient per their plans Nutrition Counseling benefit.

Out of State Blue Cross Blue Shield (i.e. Horizon of New Jersey, Anthem…)

  • Patient pays up front, Eat Right Bucks County will submit claim to insurance and insurance will reimburse patient directly if they have Medical Nutrition Therapy coverage.
  • Patient needs to call and check insurance plan coverage as each out of state plan varies with their level of coverage. We are familiar with many out of state plans. Please feel free to call our office with any questions.

United Healthcare

  • Patient pays up front, Eat Right Bucks County will submit claim to insurance and insurance will reimburse patient directly if they have Medical Nutrition Therapy coverage.
  • Preventive care not always covered but certain diagnosis can be covered.Patient needs to call and check insurance plan coverage or Call Eat Right Bucks County with any questions.

Highmark BCBS

  • Patient pays up front, Eat Right Bucks County will submit claim to insurance and insurance plan will reimburse patientif Medical Nutrition Therapy is a covered benefit.
  • Patient needs to call and check insurance plan coverage or call to check with Eat Right Bucks County with any questions.

Cigna

  • Patient pays up front at time of their appointment BUT we will submit the visit to Cigna to be reimbursed by their payer if Medical Nutrition Therapy is a covered benefit.
  • Usually 3 preventative visits and usually unlimited visits for certain conditions (i.e. Diabetes
  • Patient needs to call and check insurance plan coverage or call Eat Right Bucks County with any questions.

Insurances Not Accepted

Medicare, Medicaid, and Secondary Medicare Plans (example: Keystone 65)

* For those who’s insurance will not cover nutrition counseling, pleasecontact Eat Right Bucks County to discuss out of pocket costs for counseling. Eat Right Bucks County does not accept Medicare/Medicaid and operates separately from referring providers.

Contacting your insurance company
We strive to keep up to date on insurance plan coverage.

We ask all patients verify your own insurance coverage for our services as well.

What to ask insurance company?

It’s easy…Call the customer service department (number on the back of your insurance card) and ask the following questions:

  1. Do I havecoverage for Nutrition Counseling or Medical Nutrition Therapy?

(insurance codes 97802 or 97803 if they ask)

  1. How many visits are you permitted per year?
  2. Am I permitted to see a Registered Dietitian for Nutritioncounseling?
  3. Do I have a copayment, co-insurance, or deductible to meet?
  4. What medical conditions are covered for nutrition counseling?
  5. If you have an out-of-state plan: Can I see a local in network Registered Dietitian?