As a courtesy, Alo Nutrition will submit claims to your insurance company as in-network providers. If we are out-of-network, we will not submit claims but can provide a superbill upon request.
Alo Nutrition does not verify benefits and eligibility. It is the responsibility of the client to contact the insurance company to learn about their benefits & eligibility for nutrition counseling. Please use our nutrition benefits script when talking with your insurance provider. Please note that quoted benefits & eligibility are not a guarantee of payment.
Claims will be submitted after services have been rendered. Insurance has 45 days to review and process claims before Alo Nutrition is notified of the outcome. Once the claim is processed and we receive details through the insurance portal, we will charge the credit card on file for any copay, coinsurance or deductible indicated as patient responsibility.
If your claim has been denied we will resubmit the claim once on your behalf and notify you that the claim has been resubmitted. If the claim is denied a second time, we will notify you of the denial and charge the credit card on file for the appointment at the self-pay rate in the billing agreement. Once a claim has been denied a second time all future sessions will be self-pay. If claims are denied and/or indicate we are out-of-network, we cannot appeal and you will be charged the self-pay rate in the billing agreement and all future appointments will be self-pay.
Alternatively, if you would like us to continue to appeal your claim for a second (or more) times, there will be a service fee of $50 for each additional appeal you would like us to submit. Additional appeals do not guarantee we will be able to overturn the denial and you may ultimately still be responsible for the full cost of the appointment.
If your plan requests a letter of medical necessity, we will submit the information required by the plan. Please note that a letter of medical necessity is not a guarantee of payment.
Currently, many insurance companies recognize telehealth as a reimbursable location for nutrition services. However, if there is a reversal in telehealth benefits, we will notify you and all appointments will be self-pay per the billing agreement.
Insurance is complex! If you are interested in learning more, we highly recommend checking out the Project Heal Insurance Hub.
At Alo Nutrition it is our belief that any time you meet with a dietitian, it should qualify as preventative services. For example, you are trying to prevent a medical condition from worsening or you are trying to improve lab values. However, insurance companies do not define preventative services that way. When the Affordable Care Act went into effect, preventative benefits were put in place to meet with a dietitian only if a person meets certain criteria.
Insurance plans consider nutritional counseling a medically necessary preventative service for children and adults who are “*bese”* and for adults who are “*verweight”*, and have cardiovascular disease risk factors (such as hypertension or dyslipidemia) or impaired fasting glucose, or metabolic syndrome, and when it is diagnosed and prescribed by a physician to be provided by a registered dietitian who is in network with the plan.
Depending on your specific plan, preventative benefits might be available to you for coverage of nutrition counseling services and you might not need to meet your deductible to use these benefits. To learn more about your preventative benefits please contact your insurance carrier.
*At Alo Nutrition we are weight inclusive dietitians. We understand how triggering and problematic the O words can be. We are using this language to describe how and when you can utilize benefits through your insurance plan. We do not agree in the use of the O-words but if insurance needs these words documented we may need to use them in your chart or in your medical claim. We will only do so with your permission.
Download this document & use it when talking with insurance.
Download the benefits scriptIt is important to know that if you have nutrition benefits you will need to meet preventative benefit guidelines or have a medical condition that warrants meeting with a dietitian.
If you do not have a medical diagnosis we can bill for or if you don't meet preventative benefits insurance will likely not cover for these appointments.
Alo Nutrition
13100 Manchester Road Suite 175, St. Louis, Missouri 63131, United States
Phone 314-275-0658 Fax 833-860-7211
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