If you’re trying to navigate the world of insurance at your private practice, there are certain questions you should ask insurance companies. It may not be easy to get a qualified representative on the phone, but it’s essential so you can decide if taking insurance is best for your business.
You may feel a little lost in the world of complicated jargon and legal terminology. Don’t worry! We’re here to break it down for you. Whether you’re in the process of getting credentialed or not, see how you might be able to use those credentials to help your private practice.
Here are 5 questions you should ask insurance companies to learn coverage and limitations of your client’s plans:
1. Does this company offer insurance coverage for nutritional coaching?
What qualifies an individual for coverage? (Many insurance companies provide coverage for nutritional counseling as a treatment option for obesity and/or pre-diabetic preventative care. If there are specific qualifications an individual must meet to qualify for coverage, these two are excellent things to ask about.)
2. Does this coverage remain the same across insurance plans?
Just because 1 plan within a large insurance company covers nutrition counseling services, that doesn’t mean they all do. If not, how does the coverage change?
3. Do my current qualifications provide coverage for my services?
While the many insurance companies provide some kind of insurance for nutritional care, coverage often varies between health coaches, nutritionists, and registered dietitians. It is always a good idea to see how coverage applies individually to your practice and credentials.
4. How is the extent of an individual’s insurance coverage determined?
Insurance companies have a number of ways to determine coverage. Among them, popular solutions include capping a number of sessions. For example, Aetna allows for 26 nutritional counseling sessions to treat obesity. Other popular solutions may rely on your client’s primary care physician to decide how many sessions are medically necessary.
5. Do you refer clients to me?
Many nutrition professionals say that insurance companies are their largest referral source. Therefore, it’s important to ask how the referral system works.
Every insurance company is different. Even within the same insurance company, there can be great variability amongst different specialties and regions of the country.