paperwork, paperwork, paperwork.... Grrr. I know.
Why Do I need a referral?
In preparation for your nutrition appointment, it is necessary to have a referral form completed and signed by the doctor. The referral serves as a doctor's order, provides the dietitian with vital information about your health and has less to do with insurance. Of course, if you plan to use your health insurance (Medicare, PrimeCare, IEHP, Alpha Care), a referral is pretty much required.
A release form can also be completed and signed by you to allow your doctor to release recent progress notes and labs to the dietitian which are essential to a successful office visit.
A release form can also be completed and signed by you to allow your doctor to release recent progress notes and labs to the dietitian which are essential to a successful office visit.
How to get a referral
Please print and complete the release of information form and print the referral form. Give them both to your doctor. The doctor's office can fax the fully completed forms to (951) 278-8665.
Referral Form:
| mnt_referral_form.pdf |
Release of Information Form:
| roi___notice_acknowledgement.pdf |
Patient Health Information Protection Policy (HIPAA):
| hipaa_privacy_notice.dec_2015.pdf |
Will my insurance cover nutrition counseling visits?
That depends. Every health plan and medical group is different. Always check your benefits prior to your appointment. We will try to help you with this as much as possible.
Unfortunately, many insurance plans see nutrition counseling for weight loss or to reduce health conditions as "lifestyle-related" and, therefore, do not choose to cover the service. Just like some health plans may offer a health club membership, some may cover nutrition counseling. Others feel it is the individual's responsibility.
Note to PPO patients: Most California PPO plans do not contract with Registered Dietitians. They consider dietitians to be "out-of-network providers" and are not reimbursing dietitians for claims submitted. Therefore, if you have a PPO insurance plan, you can contact your health plan to see if they would be willing to reimburse you for your payment. We will give you all the necessary paperwork, including codes and a copy of your doctor's referral; all that is required for reimbursement. PLEASE BE SURE to ask if your insurance plan covers nutrition counseling for your health conditions (many will not cover counseling other than for diabetes). Also ask if they require you meet your annual deductible before authorizing any reimbursement to you. We continually work with the insurance plans to improve this situation for you and will post an update when health plans begin to recognize the value of healthy living to prevent and reduce health conditions for all their members equally.
FYI- Aetna, Blue Shield and Cigna continually inform us that their "panel" has closed for the dietitian specialty in our area and they are not currently credentialing any new dietitian providers. We continue to pursue credentialing and will provide updates as they occur. If you have Cigna insurance, we can provide you with contact information for the two California RDs "in network" with Cigna (one in Los Angeles and one in San Diego).
Blue Cross states they accept claims from "out of network" dietitians because they do not credential dietitians. However, we have never received reimbursement on a single claim to date. Members may have more success in achieving reimbursement than dietitian providers themselves.
Unfortunately, many insurance plans see nutrition counseling for weight loss or to reduce health conditions as "lifestyle-related" and, therefore, do not choose to cover the service. Just like some health plans may offer a health club membership, some may cover nutrition counseling. Others feel it is the individual's responsibility.
Note to PPO patients: Most California PPO plans do not contract with Registered Dietitians. They consider dietitians to be "out-of-network providers" and are not reimbursing dietitians for claims submitted. Therefore, if you have a PPO insurance plan, you can contact your health plan to see if they would be willing to reimburse you for your payment. We will give you all the necessary paperwork, including codes and a copy of your doctor's referral; all that is required for reimbursement. PLEASE BE SURE to ask if your insurance plan covers nutrition counseling for your health conditions (many will not cover counseling other than for diabetes). Also ask if they require you meet your annual deductible before authorizing any reimbursement to you. We continually work with the insurance plans to improve this situation for you and will post an update when health plans begin to recognize the value of healthy living to prevent and reduce health conditions for all their members equally.
FYI- Aetna, Blue Shield and Cigna continually inform us that their "panel" has closed for the dietitian specialty in our area and they are not currently credentialing any new dietitian providers. We continue to pursue credentialing and will provide updates as they occur. If you have Cigna insurance, we can provide you with contact information for the two California RDs "in network" with Cigna (one in Los Angeles and one in San Diego).
Blue Cross states they accept claims from "out of network" dietitians because they do not credential dietitians. However, we have never received reimbursement on a single claim to date. Members may have more success in achieving reimbursement than dietitian providers themselves.
