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Hi! When applying for the NPI, you would need to identify a taxonomy. Under the Health Care Provider Taxonomy Code Set are Dietary & Nutritional Service Providers, which include Registered Dietitians, Registered Dietetic Technicians, and Nutritionists. The Nutritionist description states, "A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation." Here is more information on the NPI and taxonomy descriptions NPPES Information: nppes.cms.hhs.gov/webhelp/nppeshelp/MAIN%20PAGE.html CMS Information: www.cms.gov/medicare/provider-enrollment-and-certification/medicareprovidersupenroll/downloads/enrollmentsheet_wwwwh.pdf Taxonomy Information: nppes.cms.hhs.gov/webhelp/nppeshelp/TAXONOMY%20PAGE.html#:~:text=You%20are%20required%20to%20identify,the%20Choose%20Taxonomy%20Filter%20box. Taxonomy Search: taxonomy.nucc.org/?searchTerm=nutrition

Thank you!

Great question. When applying for the NPI, you would need to identify a taxonomy. Under the Health Care Provider Taxonomy Code Set are Dietary & Nutritional Service Providers, which include Registered Dietitians, Registered Dietetic Technicians, and Nutritionists. The Nutritionist description states, "A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation." Here is more information on the NPI and taxonomy descriptions NPPES Information: nppes.cms.hhs.gov/webhelp/nppeshelp/MAIN%20PAGE.html CMS Information: www.cms.gov/medicare/provider-enrollment-and-certification/medicareprovidersupenroll/downloads/enrollmentsheet_wwwwh.pdf Taxonomy Information: nppes.cms.hhs.gov/webhelp/nppeshelp/TAXONOMY%20PAGE.html#:~:text=You%20are%20required%20to%20identify,the%20Choose%20Taxonomy%20Filter%20box. Taxonomy Search: taxonomy.nucc.org/?searchTerm=nutrition

You would still use an ICD-10 code, such as Z71.3 - dietary counseling and surveillance or a BMI code - Z68.27 - [BMI] 27.0-27.9. Some insurances only cover certain BMI ranges and other do not cover Z71.3. If needing a medical code such as for diabetes or heart disease, you would obtain from the primary doctor or specialist. They would give the specific ICD-10 code that the patient has on their chart.

Hi! Likely the claim will be denied. It isn't typical that they would send to the local plan upon receipt. You can wait for the outcome or just submit to Highmark from now. If anything, the claim would show as a duplicate and only one would pay out.

I’ll go ahead and submit to Highmark BCBS. Was also curious to see if Simple Practice would notice and forward to Highmark. Simple Practice seems to try to work out bugs when they are flagged if they can. We are planning to send a request for a meeting time/month with you for some guidance. I have other questions too now that we are submitting to insurance and the client base is growing. Thank you. Your videos are also so great to watch and thoughtful, realizing and highlighting the things that can come up on the day to day

@@KayByrnes-r6b Typically they won't forward the claim to another payer. They are primarily scrubbing the claim for errors before it is sent. Thanks for the feedback :)

Thanks for watching and I am glad the videos have been helpful :)

Great question. If you have a practice in CO, you would want to make sure you are in network with Anthem Blue Cross and Blue Shield Colorado. If your patient was in MN and has Blue Cross and Blue Shield of Minnesota, you would bill your local which is Anthem Blue Cross and Blue Shield Colorado

@@mydietitianjourney thank you so much. This was so helpful!

Thanks for the feedback and the subscription! Feel free to post any questions you have as you start. You can also schedule a free consult to chat through questions you might have: porrazzanutrition.com/for-dietitians

Thanks for watching :)

Thanks for the feedback! If there are other topics you would like to see, feel free to leave a comment :)

Yes, definitely! Thanks for watching!

Thank you for the positive feedback! Absolutely! That is actually on my list to tackle next for a video. I'm just a bit behind on content creation with managing a doctoral program :)

@ no worries at all! Thank you so much ☺️

Yes, you do need to list a physical address. Some insurances do allow virtual only. You would still indicate a home address if this is the case, but it would not be public. UPS or PO boxes are not accepted.

Which common insurance companies pay RD’s for telehealth? And which do not?

You're welcome! Glad it was helpful!

@kn8354 Hey, unfortunately, you do need a physical location to indicate for the NPI. They won't accept a PO box or virtual address [they do check].

Thanks for watching! If you are still looking for a template, feel free to email me - felicia@mydietitianjourney.com

Any provider that sees patients and plan to bill would need a CAQH account

Thanks for watching :)

Medicare and Medicaid applications are done separately from the CAQH. The CAQH is for commercial insurances. Here is some information on Medicare: ruclips.net/video/vCCc8H5wpVU/видео.htmlsi=cACOCS44PMfgAFs2

Thank you for being a follower! Glad the videos have been helpful :)

Thank you for the feedback :) Usually, the first follow-up is between 1-3 weeks. The second follow-up is usually 1-4 weeks. Follow-ups after that are based on how many visits are left for insurance coverage and patient needs. For some of my patients, I follow up with them monthly, and for others, bi-monthly.

Maybe just find another RDN instead of assuming they’re all wrong.

All cereals are processed and sugar is not inherently bad for you. Many cereals are great sources or fiber, which is “heart healthy”.

Thank you and yes :)

Yes, definitely!

I am in-network with Medicare and most commercial insurances. When I first started, I took a look at a list of commercial insurances popular in my state and started applying to those first. I am not sure your state; however, In PA, Independence Blue Cross, Blue Cross Blue Shield (Highmark), Aetna, and United Healthcare are big ones for my area. In addition to those, though I see less often are Cigna and the Federal Employee program.

Any idea on how to get Anthem and sedgwick credentialing number

Thanks for the feedback! When considering rates, a few things to consider are your level of expertise/experience, the population you serve, and what others are charging in the area for similar services. Utilizing Medicare's fee schedule (public information) can also be helpful when establishing base rates.

Hi Brenda, For face-to-face, this would indicate you are live with the patient in real, direct time. If conducting telehealth, you would utilize a modifier (like modifier 95) to indicate synchronous audio and video along with a specific place of service (02 or 10). Some insurances do not cover audio only (no camera, via phone).

With box 12 and 13, you would indicate "signature on file" if you have the patient's signature on file in another way (i.e. through your practice documents/policies)

Thank you! I don't send a 24-hour recall anymore. I do a 24-hour recall within the session. I found that it was more efficient to do in the session since I needed to ask a lot of clarifying questions to follow-up on the recall submitted prior.

@@mydietitianjourney Thanks for the reply! That makes total sense, it's probably much easier to do a thorough one during the session :)

If you have access to the nutrition care manual, that is one tool for finding handouts. Also, the Academy of Nutrition and Dietetics has handouts along with the CDC and American Heart Association.

Thank you! More content will be coming soon!

Everything shown in this video is native to the free version of Davinci Resolve

Hi Anna, I do coaching; however there are also other RDs depending on your focus area too!

Type 1 NPI!

@@mydietitianjourney Thanks!

porrazzanutrition.com/for-dietitians

As of January 2024, a graduate degree is needed to take the registration exam to become a Dietitian. www.cdrnet.org/graduatedegree