As a Registered Dietitian in private practice, these are questions I deal with on a daily basis. Currently, I receive reimbursement for my nutrition counseling services from private insurance companies, state agencies, and private industries. I am a provider for one HMO and two PPO insurance companies. Being a provider, however, does not mean that I will automatically be reimbursed for my services.
Services are subject to a review process within the insurance company.
Potential clients call to ask me whether their health insurance will cover my services. It depends on whether my services are medically necessary, whether the client has a written doctor's referral related to a medical problem, and it depends on the client's health insurance policy. Even with all the necessary documents gathered, the final outcome will depend on the decision and review process within the insurance company. Often, decision makers will first look at the list of covered benefits on the policy to determine whether nutrition services or Medical Nutrition Therapy is included. If nutrition services are not listed on the policy, the claim is often denied with the explanation that this service is not a covered benefit.