Health Insurance Coverage
The benefits for nutrition counseling vary greatly from one company to another, and even among plans. Often insurers base coverage on diagnosis. For example, some plans cover only if the member has diabetes, while others cover for a wider range of conditions in which a change of diet has a therapeutic effect. Some examples may be high cholesterol, high blood pressure, gastro-esophageal reflux disease (GERD), Irritable Bowel Syndrome, among others. Weight loss of a few pounds is usually not covered, although obesity may be covered. Occasionally, a plan may cover for general nutrition counseling, without any medical condition necessary.
If you want to be sure of insurance coverage prior to your appointment, Andrea Chernus recommends that you call the member services department of your insurance plan (the phone number should be on your insurance card). Write down the name of the person you speak with and get a reference number for the phone call. It is important to ask all of the following questions as they are written and ask the representative for an explanation if you feel they are unclear when answering you:
- Does my plan include a benefit for nutrition counseling?
- Does the plan cover for ___________ ?(Whatever your reason is; mention any/all medical conditions that you have; mention any/all conditions for which you are taking medication)
- How many visits am I allowed per year? Are there any other limits?
- Do I need a referral from my Primary Care Physician?
- Do I have a deductible? What is my co-pay?
- Is Andrea Chernus covered on my plan?
- Are there any other exclusions on my plan that would cause a claim for nutrition counseling submitted by Andrea Chernus RD on my behalf to be rejected or go unpaid?
- If Andrea Chernus is not covered, what are my out-of-network benefits?
If your plan does not cover nutrition, but you do have a Health Savings Account or Flexible Spending Account, check with your Human Resources Department that you may use it for nutrition counseling. Andrea Chernus will gladly accept payment through these plans.
If insurance coverage is denied, you are responsible for all fees pertaining to the services provided by Andrea Chernus, RD.
The following are the health insurance plans Andrea Chernus participates with, and her ID numbers
|Andrea Chernus National Provider Identifier Number (NPI):||1750403895|
|INSURANCE PLAN ID||Number|
|Blue Cross/ Blue Shield PPO*||09Q833|
|Multiplan (need to check with the underwriting insurance co.)||No ID|
|PHCS (need to check with the underwriting insurance co.)||No ID|
|Oxford Health Plans||P2634767|