Rates & Health Insurance

​Most health insurance plans cover nutrition visits with us, often at NO COST to you.

DANDELION NUTRITION ACCEPTS:

• Aetna (referral recommended, telehealth not always covered)
• Blue Cross Blue Shield (telehealth not always covered)
• Cigna
• First Choice Health / Moda Health / Health Net of Oregon
• Kaiser Permanente
  - HMO plans (referral required)
  - PPO/ Options plans
  ​- Medicare Advantage plans (Emily & Marlene only)​
• Premera Blue Cross / Lifewise
• Regence Blue Shield / Uniform Medical / Bridgespan / HMA / Asuris

​​Coverage varies greatly between plans. Please scroll down for help determining what your plan covers. If insurance declines to cover your visit(s) for any reason, you are responsible for the full amount billed.
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​If we are out-of-network with your insurance, sessions may still be covered. Upon request, we can either send a claim to your insurance on your behalf or provide you with a superbill to submit yourself for possible reimbursement. Payment is due from you at the time of service.

PAYMENT:
We accept cash, check, credit/debit cards, HSA & FSA cards.
A credit/debit card on file is required to secure appointments.

Nutrition Counseling	Standard Rates (billed to insurance)	When Paid at the Time of Service
Initial Nutrition Assessment - ​up to 85 min standard / up to 55 min Aetna clients only* *Aetna only covers up to 1 hour for all appointments. Clients preferring the usual longer initial appointment may pay $60 out of pocket for the added time not covered by Aetna.	$285 / ​$190	$225
Nutrition Follow-up - up to 55 min	$160	$140
Other Services (for established clients) i.e. nutritional analysis, letter writing, care conferences, phone or email check-ins taking >5 minutes, etc.	-	$140 /hr prorated in 15 min increments
Cut to the Chase Food Sensitivity Program (MRT+LEAP*) ​*MRT+LEAP is only available to clients enrolled in our 12 week all inclusive food sensitivity program	-	Book a free clarity call to discuss

We offer reduced rates to clients with Washington Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​
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HOW TO VERIFY YOUR INSURANCE BENEFITS:
​To verify your insurance benefits for nutrition counseling, please call the number on the back of your insurance card and ask them the questions below. Doing this will help ensure you get the most out of your benefits and avoid unwanted financial surprises. 

• Do I have benefits for nutritional counseling, CPT codes 97802 & 97803?
• Do I have any nutrition counseling benefits covered under the preventative care portion of my plan? (ICD-10 code Z71.3)
• Is a doctor’s referral required?
• Is there a limit on the number of visits allowed?
• Are there any restricted diagnoses?
• Are telehealth/ virtual visits covered?
• Do I have a deductible to meet before insurance pays?
• Do I have a co-pay or co-insurance?
• Is Dandelion Nutrition and/or my preferred dietitian/ nutritionist a covered provider under my plan? If not, what are my out-of network nutrition benefit?

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NOTES ABOUT EACH INSURANCE COMPANY:
We have listed some information below regarding insurance coverage for nutrition therapy based upon our knowledge and/or experience to date with the companies.​​​ Please understand that we absolutely cannot know the details of each plan and that the information below is not a guarantee of coverage. We do not regularly check benefits for clients so it is your responsibility to know what your plan covers and what your portion of the cost is.

Aetna

• As of March 2019, Aetna has changed their coverage guidelines. They no longer cover Z71.3 as a diagnosis code. Please have your doctor fax us your ICD-10 diagnosis list or a referral with an ICD-10 diagnosis to help ensure Aetna covers your visit with us since we are unable to diagnose medical conditions ourselves.
• Some plans do not cover telehealth, so be sure to call and ask Aetna.
• Detailed information on coverage can be found in Aetna's Policy for Nutritional Counseling.
• All appointments are limited to 1 hour, so initial appointments will need to be only 55 minutes, or you can pay out of pocket for the extra time of a full intake session (up to 85 minutes).

Amerigroup

We do not accept Amerigroup. However, reduced rates are available to clients with Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​

Ambetter Coordinated Care

• We do not accept Ambetter Coordinated Care.
• For Apple Health (Medicaid) plans:  Reduced rates are available to clients with Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​
• For Marketplace plans:  We are an "out-of-network" provider, meaning you will be responsible for the fee at the time of our appointment and, depending on your plan, a certain amount of that may be paid back to you by your insurance company.​ Upon request, we can either submit the claim on your behalf or provide you with a form to send in to them for possible reimbursement.

Blue Cross Blue Shield

• A doctor's referral is typically not required.
• We can accept any out-of-state BCBS plans such as Anthem Blue Cross, BCBS of Illinois, BCBS Federal, etc.
• Washington state telehealth laws may not apply to out of state plans.
• Generally, Blue Cross Blue Shield's Federal Employee Program (FEP) covers 6 nutrition visits annually, with additional visits permitted when medically necessary.

Cigna

• ​A doctor's referral is typically not required.
• At least 3 wellness/ preventative visits are covered per year at 100%, meaning no cost to you. 
• Cigna's Preventative Care Services Policy

Community Health Plan Of Washington

We do not accept CHPW. However, reduced rates are available to clients with Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​

First Choice Health / Moda Health / Health Net Plan of Oregon

• A doctor's referral is typically not required.
• Most plans cover visits in full, however some do require a copay/ coinsurance.
  

Kaiser Permanente of Washington

• HMO plans require a formal referral/ prior authorization. They usually authorize 6 visits initially with re-authorization required for additional visits. Authorizations expire after 6 months. Although we will help request additional authorizations, it is the ultimately the client's responsibility to ensure proper authorization has been obtained prior to any scheduled appointments.
• PPO or "Options" plans do not require a referral or prior authorization to see us.
• Some plans have a different copay amount due for primary care visits vs. specialist visits. In most cases, KP considers us specialists.

Medicare

• Medicare clients may only see RDNs... Medicare does not cover Certified Nutritionists (CNs).
• Nutrition therapy is ONLY covered with a diagnosis of diabetes or pre-dialysis kidney disease. Medicare does not cover pre-diabetes or any other diagnoses. 
• Medicare limits the amount of nutrition therapy to 3 hours for the first calendar year you received nutrition therapy, whether nutrition therapy was provided by us or another dietitian or institution. Medicare limits the amount of nutrition therapy to 2 hours for the second calendar year.
• A doctor's referral is always required. Have your doctor fax it to us at (206) 866-0204. It is the client's responsibility to ensure the referral has been received prior to any scheduled appointments.
• ​If you have coverage through a medicare advantage plan, additional diagnoses may be covered.

Molina Healthcare

• We do not accept Molina Healthcare.
• For Apple Health (Medicaid) plans:  Reduced rates are available to clients with Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​
• For Marketplace plans:  We are an "out-of-network" provider, meaning you will be responsible for the fee at the time of our appointment and, depending on your plan, a certain amount of that may be paid back to you by your insurance company.​ Upon request, we can either submit the claim on your behalf or provide you with a form to send in to them for possible reimbursement.

Premera / Lifewise

• A doctor's referral is typically not required.
• Usually very good coverage. If not treating a specific medical diagnosis, nutrition counseling may fall under your preventative health benefit which is typically covered in full by the plan, meaning no cost to you.
• Diagnoses of either diabetes or eating disorders usually not subject to number of visit limits.
• We are considered an in-network provider for the Marketplace plans, however it is unclear still if a referral is required since they are EPO plans. Please ask your insurance company.

Regence / Uniform / Bridgespan / Asuris / HMA

• ​A doctor's referral is typically not required.
• Usually very good coverage. If not treating a specific medical diagnosis, nutrition counseling may fall under your preventative health benefit which is typically covered in full by the plan, meaning no cost to you.
• Preventive visits and diagnoses of either diabetes or eating disorders usually not subject to number of visit limits (i.e. 3 per lifetime).

United Healthcare

• We do not accept UHC.
• For Apple Health (Medicaid) plans:  Reduced rates are available to clients with Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​
• For all other UHC plans:  We are an "out-of-network" provider, meaning you will be responsible for the fee at the time of our appointment and, depending on your plan, a certain amount of that may be paid back to you by your insurance company.​ Upon request, we can either submit the claim on your behalf or provide you with a form to send in to them for possible reimbursement.

Washington apple health (Medicaid)

We do not accept Washington Apple Health (Medicaid). However, reduced rates are available to clients with Apple Health (Medicaid) plans. Please contact us to discuss rates and eligibility.​