Paying With Insurance

Step 1:  Determine whether we are  “In Network” of “Out of Network”

We are a Preferred, In-Network Provider with most of the major networks:

    • Anthem
    • Aetna
    • Cigna
    • Maine Community Health Options
    • United Healthcare
    • Harvard Pilgrim

Plan names can vary within network (for example, Great West is affiliated with Cigna). If you are unsure whether your insurance provider is a connected with one of the networks above, either call the member services number on the back of your insurance card or go to your insurance’s member site and search for one of our providers (listed as a Specialist) or “New Roots Nutrition Counseling” (listed under facilities).

Step 2:  Determine Your Plan Benefits

Call the member services number on the back of your insurance card. Tell them your status:  “In Network” or “Out of Network”. Then ask:

    • Does my plan cover medical nutrition therapy and/or nutrition counseling?
      • If yes, is this benefit limited to a specific medical diagnosis?  What diagnoses are included?  Are there any medical diagnoses that are specifically excluded?
    • What nutrition services are covered under the preventive services benefit of my plan?
    • Do I need a referral?  Is so, who can make the referral?
      • If Referral is Needed: If a medical diagnosis is required for benefit eligibility, you will need a referral.  Please call your physician or other medical professional and have a referral faxed to my office, no later than 48 hours prior to our appointment. You will need to give your referring provider my Fax Number: 844-308-8895.  If National Provider Number is requested: 1932585213.
    • Do I have unlimited visits or a specific number of visits available each year?
    • Do I have a deductible I need to meet? If yes, how much?
    • Do I have a co-pay or co-insurance (for example, the plan pays 80% of the covered amount and you pay 20%) once any deductible has been met?

Note: These questions are provided as a guide to help you determine if nutrition counseling may be covered by your insurance provider. Having these questions addressed by your insurance provider’s member services does not guarantee coverage.

Step 3:  Understand the Billing & Payment Process

If your plan benefits cover medical nutrition therapy and/or nutrition counseling, we will submit claims on your behalf whether we are “In Network” or “Out of Network”.

You will be responsible for paying the co-pay, coinsurance, or full fee (if you have not met your deductible) at the time of service.

Paying With Insurance

Step 1:  Determine whether we are  “In Network” of “Out of Network”

We are a Preferred, In-Network Provider with most of the major networks:

    • Anthem
    • Aetna
    • Cigna
    • Maine Community Health Options
    • United Healthcare
    • Harvard Pilgrim

Plan names can vary within network (for example, Great West is affiliated with Cigna). If you are unsure whether your insurance provider is a connected with one of the networks above, either call the member services number on the back of your insurance card or go to your insurance’s member site and search for one of our providers (listed as a Specialist) or “New Roots Nutrition Counseling” (listed under facilities).

Step 2:  Determine Your Plan Benefits

Call the member services number on the back of your insurance card. Tell them your status:  “In Network” or “Out of Network”. Then ask:

    • Does my plan cover medical nutrition therapy and/or nutrition counseling?
      • If yes, is this benefit limited to a specific medical diagnosis?  What diagnoses are included?  Are there any medical diagnoses that are specifically excluded?
    • What nutrition services are covered under the preventive services benefit of my plan?
    • Do I need a referral?  Is so, who can make the referral?
      • If Referral is Needed: If a medical diagnosis is required for benefit eligibility, you will need a referral.  Please call your physician or other medical professional and have a referral faxed to my office, no later than 48 hours prior to our appointment. You will need to give your referring provider my Fax Number: 844-308-8895.  If National Provider Number is requested: 1932585213.
    • Do I have unlimited visits or a specific number of visits available each year?
    • Do I have a deductible I need to meet? If yes, how much?
    • Do I have a co-pay or co-insurance (for example, the plan pays 80% of the covered amount and you pay 20%) once any deductible has been met?

Note: These questions are provided as a guide to help you determine if nutrition counseling may be covered by your insurance provider. Having these questions addressed by your insurance provider’s member services does not guarantee coverage.

Step 3:  Understand the Billing & Payment Process

If your plan benefits cover medical nutrition therapy and/or nutrition counseling, we will submit claims on your behalf whether we are “In Network” or “Out of Network”.

You will be responsible for paying the co-pay, coinsurance, or full fee (if you have not met your deductible) at the time of service.