How Does Insurance Work?
Locate the member services/customer service number on the back of your insurance card.
Call your insurance company to check for benefits. Here are questions to ask:
1. Is my provider in-network or out-network? Do I have out-of-network benefits?
Here is a list of our providers and their NPI numbers to check if they are in-network with your plan.
Tax ID# 26-4506413
Andersons Nutrition – NPI # 1508180829
Andersons Nutrition HighMark – NPI# 1396221347
Nicole Anderson Goodrich- NPI # 1194966879
Christine Babey- NPI # 1720380348
Christina Brochet- NPI # 1538550504
Michelle Hines NPI # 1609938711
Heather Gauthier NPI # 1528315900
Andrea DaRosa NPI # 1932412152
Tammy Leeper NPI # 1225688013
Taylor Aasand NPI # 1164900478
In-Network– We will bill your insurance directly and will bill you for any deductible, co-pay, or co-insurance that your insurance does not cover.
Out of Network– No problem! We are happy to bill your insurance even if you only have out-of-network benefits. The cost of the appointment will be collected from you at the time of visit and you will be issued a refund once we receive payment from the insurance company. Often times, you will receive a full refund. *Please note that some insurance companies will reimburse you directly.
2. Does my policy cover nutrition counseling and/or medical nutrition therapy?
See if these CPT codes are billable:
- 97802 & 97803
3. What conditions and/or diseases are covered? (ICD-10 Codes)
- Z71.3- Healthy Eating
- E11- Diabetes type 2
- E66.9- Obesity (BMI >30)
- E78.5- Hyperlipidemia/High Cholesterol
- K58.0/K58.9- IBS
- E28.2- PCOS
- K21.0- GERD
- I10- Hypertension (high blood pressure)
- K90.0- Celiac Disease
- Z91.01- Food Allergy
- R73.09- Abnormal Blood Glucose (Pre-diabetes)
- Find more diagnosis codes to use HERE.
4. What is my cost?
A. Do I have a deductible?
B. Do I have a co-pay?
C. Do I have a coinsurance?
*Often times with preventive counseling, there is no out-of-pocket cost.
5. How many visits do I get?
Tip: When does my plan renew? January or which month?
6. Do I need a referral?
Many plans do not require a referral. However, if you do need a referral, be sure to call your primary care physician to get a referral faxed to us at (484) 310-7755. Be sure to follow up with us to ensure that we received it.
7. Where can services be rendered?
Can be in office or through Telehealth (over the phone).
8. What is the reference number for this call?
You must get a reference number. At times, the benefits stated don’t reflect what happened to the claim. Getting the reference number will help in case of a denied claim.
Let’s schedule you! You will be e-mailed the forms prior to your appointment so please remember to add in your benefits summary that you checked on in Step 1. For example: how many visits are covered, to which CPT and ICD-10 code. We can always assist you in contacting the insurance company if you have any questions.
Questions or having issues? Call us!
*Medicare or Medicaid
Not all of our providers participate in these programs. If you are insured through either of them, be sure to tell us so we can get you in with a dietitian that participates.