Preparing for Initial Sessions

Building rapport with patients in your initial sessions will be paramount to your success as a Nourish dietitian. Effectively preparing for each initial session is critical to consistently provide an excellent patient experience. Take time to carefully review the steps below so that you feel confident going into initial sessions with new patients.

During intake, patients are prompted to complete a Nutrition Intake Form. While this form is not required, it is highly encouraged to gather medical / nutrition history and health goals. If patients have not completed it, they do not have to, as you will collect the information in your initial session.

The data from the Nutrition Intake Form pre-populates into the patient’s chart note, which can be viewed ahead of the initial session.

Accessing patient charts in advance won’t impact the timeline for signing and locking notes - the expectation that they be completed within 48 hours begins at the session start time.

During intake, patients are also asked to complete a Release of Information form. This allows our team to access medical records and coordinate with insurers for billing purposes. Additionally, patients may wish to complete ROIs for external care team providers and/or family/friends who should receive care updates.

Prior to your initial session, review the completed ROI forms to ensure the information is appropriately collected. If the patient does not want to complete an ROI, they can simply type “None” for the ROI.

While it should not be the first option, there may be times you feel that your patient may be better served by another dietitian, whether it be due to specialty matching, counseling style, or scheduling availability. In these cases, it is appropriate to initiate a patient transfer. Not every patient will be a perfect match, and you should try to meet your patient where they are, but in rare cases a transfer may be the best approach.

Please take time to review our policy in full, as well as the patient transfer flowchart below.

The key takeaways are:

If a patient cancels a session with less than 24 hours notice we charge the patient a No Show Fee and the RD is compensated at their full session rate. It is considered a late cancel only if the patient contacts the RD within 24 hours of the appointment.

RDs will decide if they want to charge for a late cancel / no-show or not by selecting whether or not the patient is charged directly in the Provider Portal.

If the patient contacts the RD to cancel the appointment outside 24 hours, regardless of if seen by the RD outside 24 hours or not, the RD will need to update the status of the appointment to “Cancelled.”

If a provider has to move an appointment, it should always be marked as cancelled, even if it’s within 24 hours.

We expect RDs to wait for at least 15 minutes before they close out of the video session and change the status to a “No-Show.” See below for guidance on how to reach out to a patient that is late:

• 5 minutes after session begins:

  • Reach out to patient via email and/or phone (using *67 to hide your number), if patient doesn’t answer, please leave voicemail encouraging them to contact you via email

• 15 minutes after session begins:

  • Close out of video session but monitor email for response to earlier communication

“No-Show” appointments are charged at a rate of $75. Providers are compensated at their full session rate for any No-Show appointments.

It’s understandable that patients have questions or concerns regarding their insurance coverage. While we do not expect dietitians to handle insurance inquiries, we do ask that you know how to navigate these questions so that patients can have peace of mind in session. Please carefully review the patient insurance FAQs below.

Patients may try to cancel or not schedule a second session due to insurance, and you should reassure them of our risk-free approach and implore them to continue care.

• Q: What insurance companies is Nourish in-network with?

  • A: We currently work with Medicare (including WellMed), Blue Cross Blue Shield (this includes BCBS plans of any state and any associated plans such as Anthem, Highmark, Independence, etc.), Cigna, United Healthcare (including UMR, Oxford, and Student Resources), and Aetna (including Meritain). We do not accept Medicaid at this time.

• Q: What am I going to owe for my session?

  • A: You can use the coverage calculator on our website for estimates on cost-share and visit limits. If your insurance denies payment or your claim goes to a deductible that you don't wish to contribute to, we will not charge you for any sessions that have already occurred, so you can be confident that we can have a follow up session. For specific benefit details, you can contact your insurer directly by calling the Member Services number on the back of your insurance card. Inquire about “Medical Nutrition Therapy”.

• Q: What do you mean it is “risk-free” to try Nourish?

  • A: It is risk-free to try Nourish! If your insurance denies payment or your claim goes to a deductible that you don't wish to contribute to, we will not charge you for any sessions that have already occurred. We will reach out to you personally to determine payment options for future sessions if you wish to continue working with your dietitian. We also offer private pay services if your insurance does not cover sessions for $145 per session.

• Q: How many sessions are covered by my insurance?

  • A: Most patients receive unlimited visits. If your plan has a visit limit, we will reach out to you via email before your first appointment to notify you. If you end up having a surprise visit limit, we will not charge you for any denied sessions!

• Q: Can I use my HSA / FSA to pay for sessions?

  • A: Yes! You are welcome to pay using HSA or FSA funds.

• Q: "I see a $200-500 charge from my insurance company on a single appointment, do I owe that??”

  • A: Nourish does bill $2 - 500 based on our rate contracted with insurance, although we get paid much, much less than that (this is just how we have to bill to be compliant with the contracts). Patients are never responsible for paying for denials (with the only exception being if they lied about their insurance coverage upfront, which is rare), so you will never owe $2 - 500 for an appointment! Unfortunately we have no control over their insurance showing the 'you may owe $2 - 500 message' on Explanation of Benefits (EOB) forms - we would love to get rid of it if we could!

You can join Zoom calls directly from the Provider Portal! You will see a “Join Zoom” button on the row of the appointment, 20 minutes before the appointment starts, through the end of the appointment.

There’s a lot of ground to cover in the initial session, and it’s essential to focus on building rapport while holding an effective, organized session. Check out tips and tricks for the initial session overview below!

We often hear from new Nourish dietitians that the biggest learning curve is our chart note. Take time to carefully review our charting training below, and don’t hesitate to reach to a Clinical Quality Manager if there’s anything we can help clarify.