Working with your health insurance
When you inquire about starting services at TLB Nutrition Therapy, you will be receive an insurance questionnaire. The TLB Admin will be check benefits for you, but we also recommend you calling your insurance and checking benefits from member services. This is to ensure that we both are receiving the most accurate quote of coverage. We cannot guarantee the coverage of your insurance benefits or reimbursement, but this questionnaire will help answer those questions
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Aetna, including CVS marketplace plan
Blue Cross Blue Shield, Anthem, Blue Shield, etc.
BCBS Chip, Star, Star Plus, Star Kids Medicaid
Cigna
Sana
Superior and Ambetter Medicaid
Texas Medicaid
This is subject to change at any time.
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We are contracted with Blue Cross Blue Shield of Texas (BCBS of TX) and will be submitting into our local network. However, BCBS of TX will be communicating with your local plan to obtain coverage and if nutrition sessions are a covered benefit, then we will be considered in-network. This can be discussed further in the intro call with the TLB staff.
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Is Christina Laboy NPI: 1669741187 currently an in-network-provider for my plan? *Please note that if you are not planning to see “Tina” no worries - the other dietitians will be covered if the above NPI for “Christina Laboy” is covered (we are all under the same plan)
If not, what are my out-of-network benefits for outpatient nutrition counseling?
Please know - insurance checks benefits on the CPT code (97803 is what we use) and the diagnosis code (this is specific to the client, but it will be an ICD 10 code)
Does my plan cover the following CPT codes:
97802 code
97803 code
97804 code
Does my plan cover the following ICD-10 codes:
F50.9 - Eating Disorders
Z71.3 - dietary counseling and surveillance
Z72.4 - inappropriate diet and eating habits
E11.9 - diabetes
You can also ask about any other medical code you might have (ICD 10 code) with the CPT code 97803
Does my plan cover Telehealth services for the above CPT codes?
We highly recommend calling your insurance. We often misquoted when requesting insurance benefits. So it is best you understand your coverage with member services. We can assist you future with this in your intro call with Tina
There are many more questions that you can ask, but those are a few to start.
Please note: if you have a PPO plan we will be in-network. If you have a HMO plan or a plan that requires a referral we might be listed as out-of-network until there is a referral from your doctor. We will obtain this referral for you, after your intro call with Tina
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You as the client have the right to request a "Good Faith Estimate" per the No Surprise Act. If you would like an estimate of your self pay services or out-of-network costs, you may request this from your dietitian. Please note that this is an estimate of services and may be an under or over-estimate of the total costs. This estimate is to ensure that you are not receiving any surprise costs. To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call HHS at (800) 368-1019.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call (800) 368-1019.
