Checking Your Benefits

Get clear on your insurance benefits!

Prior to Attending An Appointment

 

We ask that you obtain an explanation/verification of benefits for our services. To do this, before you attend an appointment with us, call your insurance provider by using the 800 number on the back of your card. We know this takes extra time to check before you come in, but we don’t want you to have any surprises when it comes to your coverage.  

  

Questions to Ask Your Insurance Representative

1. Ask “what nutrition and/or mental health services are covered and how many visits are provided?” Use the procedure codes (also called CPT codes) below.

 

CPT 97802 (nutrition initial visit)

CPT 97803 (nutrition follow-up visit)

CPT 90791 (mental health initial visit)

CPT 90837 (mental health follow-up visit)

If they ask for a diagnosis code, we've listed the most commonly used codes at the bottom of the page for you to reference.

Follow up to ensure we are in your network by using our NPI number

Aspire's NPI number is 1093315244 

If we are not in your network please proceed to Out of Network Benefits towards the bottom of this page.

 

2. Ask “Are preventative care or wellness services covered under my plan?” If yes, ask "how many sessions do I have per calendar year?" 

 Be sure to get a call reference number to give us during your first session.

 

3. Ask "Do I need a referral from my PCP?"

If you need a referral from your PCP with your plan you can request Aspire Nutrition using our NPI# 1093315244.

Our fax number is 678-742-8047

Know Your Co-Pays, Co-insurance and Deductibles

 

 

 

 

Plan to pay any co-pays you may have and make it a point to know any deductibles that may apply. If an insurance claim is denied, it is your responsibility as the patient to pay any remaining balance in full.

Out-of-Network Benefits

If we are not an in-network provider for your plan we may be able to use out of network benefits and provide courtesy billing on your behalf.

 

Questions to ask your insurance representative:

 

1. Ask “Does my plan include out-of-network benefits for mental health care and/or nutritional counseling? Specifically, for outpatient services?” If yes, "How many sessions do I have coverage for?"

2. Ask“Do I have a deductible for out-of-network services? If yes, "What is the remaining amount I will have to pay before my health plan will pay?”

3. Ask “What is my coinsurance? and What is the maximum amount my plan will reimburse?"

 

For mental health service - CPT code 90837 with a Psychotherapist

and/or

For nutrition counseling - CPT code 97803 with a Dietitian 

 

Common Diagnoses Codes for Nutrition 

  • Z71.3 - Dietary counseling and surveillance

  • F50.00-F50.9 - Eating Disorders

  • Z72.4 - Inappropriate diet and eating habits

  • R73.03 - Prediabetes

  • R73.01 - Impaired fasting glucose

  • E13.65 - Other specified diabetes mellitus with hyperglycemia (Diabetes)

  • E78.5 - Hyperlipidemia, unspecified (high cholesterol)

Common Diagnoses Codes for Mental Health

  • Z71.9 - Counseling, unspecified

Are you ready?