Holy Cow!
THIS is THE billing guide every insurance-based dietitian has been waiting for: The Reimbursement Dietitian's Cheat Sheet for the Major National Insurance Companies: Aetna, UnitedHealthcare, Cigna, Blue Cross Blue Shield & Medicare.
Just to be CRYSTAL clear - there are other small, regional insurance companies like Humana, CTcare, Emblem, and Harvard Pilgrim. Those smaller plans are NOT addressed in this cheat sheet. I also DO NOT address any Medicaid plans.
This Cheat Sheet JUST covers the billing nuances for Aetna, UnitedHealthcare, Cigna, Blue Cross Blue Shield & Medicare.
The information contained in this cheat sheet is NOT intended to replace verifying your patient’s MNT benefits. My hope is that this information ‘points you in the right direction’ regarding the UNIQUE and sometimes frustrating nuances of individual insurance companies.
Also, just double-, triple-, quadruple-confirm -- the CheatSheet is only for billing. Credentialing and/or business set-up is NOT addressed anywhere in this CheatSheet.
In addition, if you are brand spanking NEW to accepting insurance (Welcome!) but pretty please (with sugar on top) understand this billing sheet is 1/10000th of what you will need to know to be successful in billing insurance. Don't get me wrong. This Cheat Sheet is worth its weight in gold. But I want to make sure you are aware that you are not going to learn everything you need to know about billing insurance and live happily ever after.
As you will see, EACH insurance company has its own 'secret handshake' when it comes to billing.
You must use the proper CPT code in combination with a known (and verified!) ICD 10 code. In addition, each insurance company has specific rules regarding exactly HOW they require you to bill to identify a telehealth visit. I do my best to outline these key combinations in the Cheat Sheet.
For each of the major insurance companies (Aetna, BlueCross BlueShield, Cigna, Medicare & United Health Care), I share:
- What CPT codes do they typically accept
- What ICD 10 codes do they typically accept
- The current telehealth codes that they are requesting RDs to bill with
- Typical billing limitations
- How each of the insurance companies defines 'preventative' services
- Best practices for maximizing getting paid
However, just to reiterate, this fabulous Cheat Sheet is NOT intended to replace verification (or your patients' verification) of MNT benefits.
Soooo important that I am actually providing you with an awesome Verification of Benefits when you purchase the Cheat Sheet. I would highly recommend you verify your patients' MNT benefits until you know each plan by heart. I would say this is the single biggest error I see dietitians make. And unfortunately, this is a costly mistake.
Pinky swear you will have someone verify your patient's MNT benefits before their visit?
Okay, kool!
I hope you enjoy these goodies as much as I do.
Cheers to your success!
Hugs & High Fives - Amy