If you would like us to check your specific insurance policy’s coverage for nutritional counseling at no cost or obligation to schedule, please enter the following information. We aim to get back to you with the results of your eligibility estimate within 3-5 business days.

We are currently in network with AETNA, CIGNA, UNITED HEALTHCARE and TRICARE EAST. Therefore, we only verify benefits for those insurance companies. If you have another insurance and would like to inquire about your out of network benefits, you can call the insurance company and ask if you have out of network benefits for Medical Nutrition Therapy for CPT codes 97802, 97803 and 99404. If you have any diagnosis(es), please provide that to the representative as well.

Fields marked with a * are required.

Insurance Company

Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Reason for Seeking Nutrition Counseling

Do you have a formal diagnosis? (ex: eating disorder diagnosis or medical diagnosis)

Yes

No

Unsure

If yes, provide diagnosis for benefits check

Location

What state do you reside in?

Insurance ID#

Group #

Primary Cardholder's Name

Primary Cardholder's Date of Birth

MM

DD

YYYY

Phone Number Listed on Card for Provider Services

(###)

###

####

Email

Contact Phone Number

(###)

###

####

*By submitting this form you are agreeing to be added to our newsletter. You can opt out at any time.

*By submitting this form you are agreeing to communication with our office via phone and text.

Insurance Benefits Inquiry