Verifying patient benefits for medical nutrition therapy

Recently, we have had an influx of demand from companies who provide medical nutrition therapy (MNT) via dieticians who need help with verifying their patient benefits.

Given these codes are newer, there is very little benefits information online. This makes the verification of benefits process more difficult as not only do you have to call, but you also have to understand how to ask the right questions to the payer representatives when you call. Given most representatives are unfamiliar with what MNT is or the codes you give them, they are likely to give you the wrong information unless you know exactly what to ask and how to ask. 

We have developed a verification of benefits process at One Body, specific to MNT. Below are some tips on how to verify benefits for MNT.

1) Make sure you always ask if the diagnosis code is preventative or medical, or both

This is very important for billing purposes and you should consult with your biller on how best to use this information when submitting claims.

2) Make sure you specify if its telehealth or office visit 

This matters as it will impact the benefits given. Sometimes MNT will be covered but not virtually. Sometimes the patient will have telehealth benefits but not when it comes to MNT. This is important to check.

3) Confirm network status

Make sure you know if the dieticians in your network are in or out of network. While payer reps will confirm network status, if you ask them what is the provider’s network status, they will usually reply with “you should know if you are credentialed or not with us.”

4) Make sure you hire a credentialer and biller to confirm which codes you can bill under

There are tons of codes and we have found that the clients who do the proper research and know what codes cover what, and how to correctly bill for them, tend to have the highest reimbursement rate. Some codes in MNT are 97802 and 97803. We will always check coverage details of CPT codes on our calls to payers.

We help several MNT providers. If you are an MNT provider and you need help with verifying your patient benefits, please reach out!