Frequently Asked Questions  & Insurances

SERVICES

* What is a Registered Dietitian/Nutritionist?


A Registered Dietitian (RD) Nutritionist (N) is a food and nutrition expert who has met the minimum academic and professional requirements to qualify for the credential "RD".


An RD or RDN provides nutritional counseling and/or Medical Nutrition Therapy to patients with medical problems affected by or contributing to nutritional status. This includes the assessment of a patient's medical history, personal preferences, habits, and lifestyle, nutritional treatment, and evaluation. Personalized education sessions are provided for enhancing nutrition status and for disease prevention.

Read more about qualifications of a Registered Dietitian Nutritionist.




* Business Concept - What kind of medical conditions do we deal with?


We provide nutrition counseling for healthy people and individualized Medical Nutrition Therapy (MNT) to treat certain medical conditions.

Individualized MNT is focused on kids, adults and pregnant women with Diabetes, cardiovascular conditions (cholesterol, high blood pressure, etc), gastrointestinal disorders (IBS, SIBO, yeast, intestinal bacterial overgrowth. …tube feeding), some autoimmune conditions such as rheumatoid arthritis (RA), Hashimoto's, food allergies, kidney disease, cancer nutritional needs and Weight Management issues (obesity, overweight, unintentional weight loss, etc.)




* How are services provided? Individually or in groups? Virtual or in-person?


We offer in-person individual visits as well as video/virtual -TeleHealth visits. At this moment and due COVID 19 we do NOT offer group visits.

Due to COVID19 we recommend all the first visits to be made virtually and based on your needs your RDN will determine where further visits will be located.

The RDN service is the same, whether in person or by TeleHealth.

The Electronic Impedance Body Composition Analysis (code 0358T for Insuracnce coverage) is only performed in person with Mrs. Wilkinson.




* What to expect during the consultation?


Some things RDN can do:

  • Review your eating habits and lifestyle, family medical history and your blood/urine laboratories
  • Thorough assessment of your nutritional status to help you understand how nutrition relates to your health.
  • Nutrition education to understand patient’s particular needs and challenges and/or create a Personalized Nutrition Treatment Plan accordingly.
  • Patient and Family Education. Patient and family education on specialized and therapeutic diets, specialized formula preparation or home nutrition support, as needed.
  • In-office Body Composition Study with Bioelectrical Impedance Analyzer. Pease see "limitations for this study" (FAQ @ Labs&Test).




* How long is the appointment?


The initial and second sessions vary in time and usually takes approximately one hour or one hour and half depending on your medical condition.

After that, it varies from 30 minutes to 1 hour session depending on your practitoner, you and your goals.

Your RDN will schedule follow-up appointments to check on your progress and see if changes are needed in your nutrition goals and treatment plan.

For example, nutrition education for healthy pregnancy, or onset of diabetes or celiac disease, is usually performed in three nutritional counceling visits.




* How many appointments will I need?


Medical Nutrition Therapy and nutritional counseling are personalized, and this defines the quantity of visits to reach the desired objective.

The quantity of appointments will depend on how hard each client is willing to work, how many nutritional issues we are addressing, and how much accountability and support each one needs.

Some people need one or two visits for education and awareness, but many clients require ongoing, multiple support to build lifelong habits. Based on your needs, your visits will be scheduled with your RDN.




* Can you work with my partner or with my whole family?


Yes, your partner or your family can be in the visit, virtual or in-person. However, each person is treated individually based on their specific medical needs and individual goals.

This means that each person will have their own appointment, but others can attend if everyone agrees.




* What is a Biomedical Impedance Analyzer (code 0358T)?


Bioelectrical Impedance Analysis (BIA) is considered one of the most reliable and accessible methods of screening body fat. BIA measures the impedance or resistance to the signal as it travels through the water that is found in muscle and fat.

To read more about BIA, go to "FAQ @ Labs&Tests".




* Do you offer remote nutrition counseling?


Yes! In addition to our in-office appointments, we offer TeleHealth visits from the confort of your home. Our virtual professionals treat clients virtually - face-to-face - from your computer or smart phone. To get an appointment, please call us at 678-407-2159




* How long is the duration of MNT?


The duration of MNT varies. Typically, the therapy stays in place until the initial goal is achieved or the nutrition-related diagnosis is resolved. However, the plan can be adjusted as needed by the RDN and your medical condition evolution.




* How do I schedule my first appointment?


To schedule an appointment, you may call us at 678-407-2159 or click on CONTACT US.




* Do you have a cancellation policy?


Yes, because your practitioner spends time just for you and many patients wait several weeks for an appointment, we must strictly adhere to a 48 hour late change / cancellation policy.

Our policy states that you must call, text or email at least 2 days before your appointment if you need to cancel or make any changes. Failure to adhere to this policy will incur a $ 50 charge.

We appreciate your understanding, as all patients who wish to be seen earlier benefit from this.




* Don’t see the answer to your question?


Reach out to us directly by clicking CONTACT US.




* What is the practice FAX number?


Our fax number for all offices is 678-780-4313





INSURANCES

Do insurances companies cover nutrition counseling or Medical Nutrition Therapy (MNT)?


YES! Many health insurance companies cover nutritional counseling EVEN if you don’t have an actual diagnosis BUT still want to come in for nutrition counseling for disease prevention.

Insurance coverage is dependent upon the insurance company as well as your insurance plan.

Most insurances cover our services at 100%, with no cost to you.

Usually, weight management, diabetes and some other medical conditions (high blood pressure, cholesterol, etc) are covered as “preventive service”.

However, even when we are participating providers at your insurance, your specific plan can or cannot cover “medical” conditions like Celiac disease, IBS, etc. so we always recommend our patients to check their benefits with their insurance member representative.




What Insurances do you take?


We are participating providers with Anthem, Blue Cross Blue Shield (and all exchanges), CIGNA, United Healthcare (all exchanges like Golden rule, All Savers, etc), UMR, Aetna, Meritain Health, Nippon, and Medicare.

We do not accept Medicaid or any Medicaid plans, but we offer special reduced fees for virtual visits to those with these Insurances if they are referred by a doctor.

Note: although we are in the network, each client's coverage policy is unique, so even though we verify your benefits, it is your INSURANCE that determines whether or not nutrition services will be covered.




OUT-of-NETWORK - What happens if you don't participate with my insurance?


If your insurance company provides coverage/reimbursement for nutrition counseling by out-of-network dietitians, we will provide you with a “Superbill” (an itemized invoice/receipt) with the necessary codes to submit to your insurance company as proof of service and payment.

Your insurance company may then reimburse you directly for all or part of the services paid.

Reimbursement is based on your policy’s standards.

* Please call your insurance company’s member services number to verify how reimbursement works under your current insurance policy.




Does the practice work with private payer clients? How much does an RD visit cost?


Yes! Please call our office at 678-407-2159 for our out-of-pocket rates for patients without coverage.

We do have special fees for patients with Insurances that do not cover nutrition services or for those that are referred by a doctor.

We can also supply a paid invoice for you to submit an out of network claim to your insurance or to your Health Savings Account for reimbursement.

We accept credit cards, HSA cards and cash.




How do I get help to find out my health care coverage and benefits?  What questions should I ask?


Contact the customer service department at your health plan through the phone number located on your member ID card, or in your enrollment materials.

These are key questions to ask:

1- Do my benefits include nutrition counseling or medical nutrition therapy?
Procedure codes 97802, 97803 or 99404?

2- If yes, am I covered under “preventive” or “medical services”?

3- Do you cover the preventive diagnosis of Z71.3?

4- Are there any nutrition exclusions or limitations in my plan? Which ones?

5- Are my visits subject to a deductible? If yes, has my deductible been met for this year?

6- Are virtual visits covered? or Are in-person visits covered? How many visits will I have covered per year?

7- Does my plan require a COPAYMENT or Coinsurance?

8- Only for adults: Is biometrical impedance analyzer (BIAS) covered (code 0358T)?
Note that BIAS are included in all in-person visits for private payers and most Insurances' first visit at no additional cost.




*.    Anthem - BCBS


Medical referral: only HMO required.
Benefits: preventive service usually cover unlimited visits.
A medical diagnosis are covered based on your specific plan.
Copay: We are considered OFFICE VISIT.

Out of State BCBS Plans

  • We can accept any out-of-state BCBS plan, but coverage varies greatly and we cannot guarantee coverage of service.
  • This may change based on your insurance plan and does not guarantee that your visit will be covered.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.

* Member benefits differ between plans, so it is recommemded that you check your Insurance Company to understand your coverage.




*.    AETNA / Coventry


Medical referral: typically, not required.
Benefits: preventive service usually cover unlimited visits.
Non-preventive, based on your specific plan. Co-payments and deductibles generally must be met.

Copay: we are considered SPECIALIST.

  • This may change based on your insurance plan and does not guarantee that your visit will be covered.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.

* Member benefits differ between plans, so it is recommemded that you check your Insurance Company to understand your coverage.




*.    AETNA / Meritain Health / NIPPON


Coverage varies greatly between individual policies

  • Some policies require a medical diagnosis for coverage or a referral from your physician, some do not.

  • If your insurance card says “Referral Required” on the front you MUST have this referral sent directly to UHC from your physician PRIOR to your appointment.

  • Deductibles and co-payments generally must be met

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.

* Member benefits differ between plans, so it is recommemded that you check your Insurance Company to understand your coverage.




*.    CIGNA


Medical referral: typically, not required.
Benefits: preventive service usually cover but some plan only allow 3 visit per calendar year with no copayment.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount. * Member benefits differ between plans, so it is recommemded that you check your Insurance Company to understand your coverage.




*.    HUMANA


We are NOT participating directly as HUMANA’s providers however if your plan is contracted with Multiplan you can be covered after October 1, 2021

We are participating with Humana only if you see Multiplan and PHCS logo on your card: HUMANA/EMPLOYEES HEALTH INSURANCE

Benefits: with Multiplan coverage varies greatly between individual Plans and policies. Please, check with your health care insurance to confirm your coverage and benefits before your visit.

* Special reduced fees provided for on-line visits with a medical referral form sent by your doctor.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.




*.    MEDICAID - Amerigroup - CareSource - Peach State Health Plan - WellCare


We do NOT accept Medicaid or any Medicaid plans:
Amerigroup
CareSource
Peach State Health Plan
WellCare

* We offer special reduced fees of U$97.00 for virtual visits to those with these Insurances with a medical referral form sent by your doctor.




*.    MEDICARE


MEDICARE Part B

Medical referral: YES, it is ALWAYS required.

Copay: NO

*ABN (Advance Beneficiary Notice of Non-coverage) form needs to be signed before your 1st. visit.

Nutrition benefits: Medicare will ONLY cover medical nutrition therapy for diagnoses of diabetes, non-dialysis kidney disease, and 36 months post kidney transplant when a Medicare beneficiary has been referred by a physician.

Medicare pay for 3 hs of MNT in the first year you need services and 2 hs in every year after that.

Additional coverage may be available in the same year with a second referral when more medical nutrition therapy is medically necessary (change in diagnosis, medical condition, or treatment regimen). This is often a missed piece of coverage. MEDICARE ADVANTAGE Some Medicare Advantage plans may also offer additional benefits, including coverage beyond these diagnoses covered by traditional Medicare. Medicare Advantage ( Medicare Part C) plans may also offer additional benefits, including coverage beyond the conditions covered by traditional Medicare.




*.    UHC / Oxford


Medical referral: typically, not required.
Benefits: preventive service usually are covered unlimited visits.
A medical diagnosis are covered based on your specific plan.

Copay: We are considered SPECIALIST.

  • Coverage varies greatly between individual policies
  • Some policies require a medical diagnosis for coverage or a referral from your physician, some do not.
  • If your insurance card says “Referral Required” on the front you MUST have this referral sent directly to UHC from your physician PRIOR to your appointment.
  • Deductibles and co-payments generally must be met

* Member benefits differ between plans, so it is recommemded that you check your Insurance Company to understand your coverage.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.




*.    UMR / UHC


Coverage varies greatly between individual policies

  • Some policies require a medical diagnosis for coverage or a referral from your physician, some do not.

  • If your insurance card says “Referral Required” on the front you MUST have this referral sent directly to UHC from your physician PRIOR to your appointment.

  • Deductibles and co-payments generally must be met

* Member benefits differ between plans, so it is recommemded that you check your Insurance Company to understand your coverage.




*.    UHC  All Savers / Golden Rule and UHC exchanges


Coverage varies greatly between individual policies

  • Some policies require a medical diagnosis for coverage or a referral from your physician, some do not.
  • If your insurance card says “Referral Required” on the front you MUST have this referral sent directly to UHC from your physician PRIOR to your appointment.
  • Deductibles and co-payments generally must be met
*Member benefits differ between plans, so it is recommended that you check your insurance company to understand your coverage. * We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.




*.    KAISER


We are NOT participating directly as KAISER’s providers, however if your plan is contracted with Multiplan you can be covered after October 1, 2021

We are participating with Multiplan and PHCS that coveres Kaiser Permanenete Insurance Company and Kaiser Foundation when the logo appears in your card.

Benefits: coverage varies greatly between individual Plans and policies. Please, check with your health care insurance to confirm your coverage and benefits before your visit.

* Special reduced fees provided for on-line visits with a Medical referral form sent by your doctor.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.




*.    MULTIPLAN  & PHCS


Beginning in October 1, 2021 we are participating with all Insurances contracted with Multiplan and PHCS.

  • Network access: Primary Network, Complementary Network, Worker’s compensation Network.

  • MultiPlan Network is a nationwide complementary PPO network.

Benefits: Coverage varies greatly between individual Plans and policies. Please call your memeber repreentative to verify coverage&benefits.

* We generally wait for the claim to be processed to determine whether or not you have a co-pay and then charge the credit card you have on file with us the co-pay amount.




Why do you keep a credit card on file?


When you sign the AGREEMENT FORM we request to store a credit/debit card on file.

We keep a credit/debit card on file for every patient mainly because co-payments, coinsurances, deductibles will be discounted from your credit card if your insurance denies coverage once we receive the EOB (explanation of benefits).

No shows without previous notice will be applied to that credit/debit card.

In case a refund is needed, our practice will refund it to that credit card.

You will always receive a secure email notification with a transaction receipt and a call from our assistant before charging for any amount of $50 or more.




I don't feel comfortable providing my credit card information. Can I skip this step?


Our practice policies require that all our clients keep a payment card on file.

If you do not agree, there are excellent professionals who do not work with this policy that you can find at https://www.eatright.org/find-a-nutrition-expert

Happily, we very rarely need to charge the card on file.





TELEHEALTH

* How to Join a TeleHealth meeting?


Joining a Meeting Your healthcare professional will send you a secure link and code to join your online appointment. The link and code is included in your appointment confirmation and appointment reminder message sent via email to you. 1. From the appointment message, you can click on the web-link or copy and type it into your browser. 2. Also, from the appointment message, make a note of the security code or copy it to your computer's clipboard (as shown below in the video). 3. You will be taken to a page where you can now paste or type in the security code. 4. Next, enter your name and ckick "START". 5. You are now in the meeting. 6. Next, click on "CONNECT CAMERA / SHARE SCREEN", and then "CONNECT CAMERA" again.
Then, click on "CONNECT AUDIO", and then "CONNECT". For more detailed information, you can watch this VIDEO.




* Is there any fee for no show?


Yes, if you do not cancel your appointment 48 hours in advance, a no-show fee of $50 applies.




* What is a TeleHealth visit?


Our dietitians can make a consultation, via your smartphone or computer, and bill your health insurance, like a standard visit to our office.

Our practice has been working with TeleHealth for a while and now, in light of the COVID-19 pandemic, we are confident that it is the best way to keep you safe while enjoying the comfort of your home or office.

TeleHealth also makes it easy for clients to contact practitioners when they live far away from the office location.




* Do I need to fill-out any form before my TeleHealth visit?


Yes, like a face-to-face visit, you must fill out the PERSONAL INFORMATION form and the AGREEMENT form before your first visit.




* Supported Devices & Browser for virtual visits


Our video conferencing feature is compatible with both Mac and PCs computers via the following browsers - Chrome (PCs, Macs & Android devices), Mozilla Firefox (PCs, Macs & Android devices), Safari (Macs, iPhones & iPads) and Edge (PCs).

* Internet Explorer - We are unable to support Internet Explorer.

This browser is not compatible with the infrastructure of Kalix's video conferencing feature. However, we do offer other face-to-face options like whatsapp but you must report this to the practice P:678-407-2159 previous to your visit so we can take care of the situation.




* How to schedule a TeleHealth visit?


1. To schedule a virtual appointment, you may call us at 678-407-2159 or CONTACT US.

2. You will receive an appointment confirmation in your email with the DATE and time for your upcoming appointment.

You will also receive two forms - Personal Information form & Agreement form - that must be filled-out on-line at least 2 days previous to your visit.

Once you complete each one, click on submit and we will securely receive them. So, you do NOT need to print the forms.

If you have any question, please call us at 678-407-2159 or CONTACT US




* Are TeleHealth visits covered by my Insurance?


Yes in most cases.
If you have a copayment (copay), a coinsurance or any deductible we will charge your credit card on file.
We recommend that all our clients call their Member Representative to check that virtual visits are covered. The codes we use are 97802 (only for the first visit) and 97803 (for follow-ups).





LABs & TESTS

* Do I need any bloodwork done for my first appointment?


We always recommend sending us your laboratories prior your visit for a better understanding of your own health. It allows us to establish the connection between the food you eat and your state of health, and the goals of your medical nutrition. Labs are a reliable way to monitor customer progress over time.




* Don’t see the answer to your question?


Reach out to us directly! CONTACT US.




* Does the practice perform laboratory tests in the office?


We do not perform laboratories in the office; however, we work with the last laboratories that you have from your annual medical visit.

Your primary care physician (PCP) or specialist is the one who follows you medically and who orders your labs.

Please, ask your doctor to FAX the last blood/urine labs or studies to FAX 678-780-4313 or complete the authorization for releasing medical information.




* Is BIAS covered by my insurance?


Please, call you health Insurance and ask for the code 0358T to find out if BIAS will be covered under your specific plan.

Some Insurances cover it but if not we have a special fee for our clients of $30.
It is possible that BIAS can be paid for by an HSA or FSA.

Not all RDs uses BIAS in the visits and it is not necessary for virtual visits.




* What is a Biomedical Impedance Analyzer Study - BIAS (code 0358T)?



Bioelectrical Impedance Analysis Study (BIAS) is considered one of the most reliable and accessible methods of screening body fat.
BIAS measures the impedance or resistance to the signal as it travels through the water that is found in muscle and fat. The more muscle a person has, the more water their body can hold. The greater the amount of water in a person's body, the easier it is for the current to pass through it. The more fat, the more resistance to the current.

Total body composition readings of this study include: Weight, Fat %, Fat Mass, Fat Free Mass , Fat % Healthy Range, Total Body Water, Total Body Water Mass, Muscle Mass, Bone Mass, Visceral Fat indicator, Body Mass Index, Physique Rating. It also, includes Metabolic readings as BMR (Basal Metabolic Rate), Metabolic Age and Bone Mass.




* Are there any limitations for the BIAS?


Yes!
This analysis method should not be done under the following conditions:

1- In people using electronic medical devices such as a pacemaker or portable electronic medical devices, such as an electrocardiograph
2 - In people with any electronic life support systems, such as an artificial heart/lung
3 - People under medical diuretic treatment because water measurment might not be accurate.




* Any special recommedation for measuring the BIAS?



The ideal condition for analyzing BIA is simply standing with minimum clothes, without shoes and socks and wearing no jewelry or accessories.
Please, come to the consultation with light comfortable clothes and easy to-remove accessories.




* What is a Basal Metabolic rate - BMR - that appears in the BIAS?


Basal Metabolic Rate (BMR) is only applicable for age 18 an older.
BMR is the minimum level of energy your body needs when at rest to function effectively including your respiratory and circulatory organs, neural system, liver, kidneys, and other organs.
About 70% of calories consumed every day are used for your basal metabolism. In addition, energy is used when doing any kind of activity. The more vigorous the activity is, the more calories are burned. This is because skeletal muscle (which accounts for approximately 40% of your body weight) acts as your metabolic engine and uses a large amount of energy. Your basal metabolism is greatly affected by the quantity of muscles you have, therefore increasing your muscle mass will help increase your basal metabolism.




* BIAS - What is the total body water percentage?



Total Body Water Percentage, only applicable for age 18 an older, is the total amount of fluid in a person's body expressed as a percentage of their total weight.

Water plays a vital role in many of the body's processes and is found in every cell, tissue and organ.
Maintaining a healthy total body water percentage will ensure the body functions efficiently and will reduce the risk of developing associated health problems. Your body water levels naturally fluctuate throughout the day and night. Your body tends to be dehydrated after a long night and there are differences in fluid distribution between day and night.




* BIAS - What is the visceral fat rating?



Visceral fat (applicable to ages 18 and older) is the fat that is in the internal abdominal cavity, surrounding the vital organs in the trunk (abdominal) area.
Research shows that even if your weight and body fat remains constant, as you get
older the distribution of fat changes and is more likely to shift to the trunk area especially post menopause. Ensuring you have healthy levels of visceral fat my reduce the risk of certain diseases such
as heart disease, high blood pressure, and the onset of type 2 diabetes.




* BIAS - What is the visceral fat?



Visceral Adipose Tissue (VAT) has been associated with increased risk of developing lifestyle-related diseases.
Accordingly, knowing and periodically checking the estimated VAT accumulation serves as one factor among a number of factors in assessing the prevention of lifestyle related diseases.




* BIAS - What is your metabolic age?


BIAS calculates your BMR and indicates the average age associated with that type of
metabolism.
If your BMR Age is higher than your actual age, it is an indication that you need to improve your metabolic rate. Increased exercise will build healthy muscle tissue, which will improve your metabolic age.




* BIAS - What is a physique rating?



This feature assesses your physique according to the ratio of body fat and muscle mass in your body.

As you become more active and reduce the amount of body fat, your physique rating will also change accordingly. Even though your weight may not change, your muscle mass and body fat levels may be changing making you healthier and at lower risk of certain diseases.




* BIAS - What is bone mass?



This feature indicates the amount of bone (bone mineral level, calcium or other minerals) in the body.

Research has shown that exercise and the development of muscle tissue are related to stronger, healthier bones. While bone structure is unlikely to make noticeable changes in a short period, it is important that you develop and maintain healthy bones by having a balanced diet and plenty of exercise.
People worried about bone disease should consult their physician. People who suffer from osteoporosis or low bone densities due to advanced age, people of young age, pregnancy, hormonal treatment or other causes, may not get accurate estimations of their bone mass. Cleared by the FDA - T- SC-331S analyzer used at Nutrition ECW has undergone a stringent review by the FDA to ensure that our customers receive the highest quality, and most accurate, service.