Checking Insurance Benefits
We are excited to work with you and value making care more accessible by being in-network providers with insurance.
If you are contracted with another company or your specific plan does not cover appointments, we are more than happy to provide you with a Superbill to submit to your insurance company for reimbursement. The Superbill is not a guarantee of reimbursement.
We ask that you verify your insurance benefits before your initial session to best help you understand what to expect regarding coverage for nutrition counseling.
To do so, you can call the "member services" phone number on the back of your insurance card and ask the questions listed below.
We are in network with:
Aetna
Cigna
Highmark Blue Cross Blue Shield
UPMC Health Plan
Is Reimagine Nutrition Counseling, LLC (NPI 1699508432) in network with my insurance plans?
Does my plan cover outpatient nutrition counseling? What are my specific benefits for nutritional counseling?
CPT (procedure) codes: 97802 and 97803
If you are asked for a diagnosis code-
If you have been diagnosed with an eating disorder, you can provide that code (example: F50.9, Eating Disorder, Unspecified)
If you have been diagnosed with pre-diabetes, diabetes, hypertension or high cholesterol you can check your coverage for these conditions
Please Note: As a weight inclusive providers, we disagree with the use of BMI as a proxy for health. That being said, sometimes insurance will cover services at no cost to you if your BMI is >25.
If you do not have a diagnosis as listed above, or if you are uncertain about what applies to you, you can check your coverage for the diagnosis code for R63.30, Z72.4, or Z71.3
If yes to the above questions, how many sessions are covered?
Do I have a deductible or out of pocket amount to meet first?
If yes, how much is my deductible or out of pocket amount?
How much have I met of my deductible or out of pocket costs?
Do I have a copay or coinsurance? If so, what is the percentage or amount?
When does my deductible renew/reset
Obtain a reference number for your call.
Before ending your call with the representative, it is strongly encouraged to obtain a confirmation or reference number as well as the representative's name who helped you. This information will come in handy should there be an issue with the claim processing
Obtain doctors referral.
Before scheduling/attending your initial nutrition counseling, we recommend requesting a doctors referral for nutrition counseling to allow us to bill your insurance for services. This referral can be faxed to 412-332-0025.
Please note: If an insurance claim is denied, we will do our best to troubleshoot, however, it is your responsibility to pay the remaining balance.