Patient Insurance FAQs

While our CX Team is here to help patient's with specific insurance questions / issues, patients may ask you more general insurance questions. The FAQs outlined below will equip you so that you can respond to general insurance inquiries. If you're ever uncertain, don't hesitate to refer your patient to support@usenourish.com for additional support.

• Blue Cross Blue Shield (BCBS) and all affiliates (such as Anthem, BCBS of any state, Independence, Capital, Highmark, etc.)

• United Healthcare (UHC) and all affiliates (UMR, Student Resources, Oxford, etc.)

• Aetna (including Meritain)

• Cigna

• Medicare (but only with a formal diagnosis of Diabetes (Type 1 or Type 2) or Chronic Kidney Disease). This includes Medicare Advantage plans hosted through commercial insurance, like AARP Medicare Advantage, Aetna Medicare, etc.

We accept Medicare! But the client will only be covered if they have a formal diagnosis on record of Diabetes or Chronic Kidney Disease. Any other diagnoses (including prediabetes, eating disorders, etc.) are not covered, and Medicare does not make any exceptions.

We do not accept Medicaid in any form.

Totally fine! We still accept it. We will make sure to bill it accordingly.

Again, totally fine! We will run the new insurance. Please note that if a client of yours switches to Medicare, they will only be covered if they have a Diabetes or Chronic Kidney Disease diagnosis, as mentioned above.

Please link them to the coverage calculator on our website here, which has our best estimate for how much their session will cost. Please note that this is an estimate, and the final cost will ultimately be determined by their insurance.

The coverage calculator on our website now provides clients with an estimate of how many visits they have covered - feel free to link them to it! It includes our best estimate of their covered visits, but if they want to confirm or want more detail, they can call the member services number on the back of their insurance card and inquire about their benefits for Medical Nutrition Therapy.

This varies by insurance provider. We get the majority claims back ~1.5-3 weeks after the session date. However, in some cases, it can be longer, depending on how long it takes insurance to process their claim.

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

Yes! Patients are welcome to pay using HSA or FSA funds.

If it is the client’s first appointment, once we get the claim back from insurance, we will send them an invoice via email explaining the charge and then charge the card on file 5 days later.

If it is a follow-up appointment, we will auto-charge the customer once we get the claim back from insurance.

Clients are responsible for paying copays and coinsurance amounts; this is a legal requirement from insurance and unfortunately we have no control over it.

We offer the client 2 options if it goes towards their deductible:

• Pay the deductible amount (and earn credit towards their deductible) and keep billing future appointments to their insurance.

• Cancel the previous claims (and owe Nourish $0) and either cancel future appointments or move to self pay for future appointments.

Offering these 2 options is a generous (and rare) policy which allows us to prevent clients from getting a surprise large bill.

Clients are not responsible for any insurance denials! The only exception is if they did not have active insurance at the time of their visit (e.g., they are uninsured and did not tell us).

When we receive a denial back from insurance, we investigate the denial and see if we can get it covered. If we cannot get it covered, we reach out to the patient to let them know that they will not owe any payment for any previous visits. We then give them 2 options moving forward:

• Continue appointments as a self-pay patient (i.e., we do not bill their insurance)

• Cancel future appointments

Again, this is a generous policy that guarantees a client will not get a surprise large bill from insurance.

Your client may see something in their insurance portal saying ‘You may owe $X’. This is something their insurance shows and we have no control over it, but they will not owe any money for a denied claim.

Nourish does bill $200 - 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 patients will never owe $200 - 500 for an appointment! Unfortunately we have no control over patients’ insurance showing the 'you may owe $2 - 500 message' on Explanation of Benefits (EOB) forms - we would get rid of it if we could!

Our self-pay rate is $145 per session. Self-pay clients are charged the day after their appointment.

We offer a limited amount of sliding scale spots for our clients most in-need. If you want to request a sliding scale rate for a client of yours, please email support@usenourish.com. Please note that we have very limited spots open (only 1 per RD as a rule of thumb).

Our no-show fee is $75, and includes any appointment late-cancelled or missed where no fee waiver was requested (or a fee waiver was submitted and subsequently denied).

Of the insurance plans that cover Nourish, only BCBS HMO plans require prior authorizations. Your patient can check their insurance card or insurance portal and see if it says "HMO" to know if they have the BCBS HMO plan. If they want additional information, they can call the member services number on the back of their insurance card.

Yes! We collect each patient’s insurance information and run it prior to their first appointment. For the majority of our clients, we also collect photos of the front and back of their card, although this is not required if the insurance check went through without issue.

A Release of Information (ROI) document allows us to collect medical records for a client. In some cases, their insurance may only cover certain specific diagnosis codes. In order to bill with these codes, we need the patient’s medical records to determine what formal diagnoses they have received. This can allow us to get more coverage for a client in instances where insurance may not have covered otherwise.