Please review the Information Here

  Kidney Nutrition Referral Form for

Your Doctor to Use

 

 

Insurance Accepted

Medicare, United Healthcare, BCBS Anthem, Aetna, Cigna, Harvard Pilgrim

 

Every person’s insurance coverage is different.  Call your insurance provider as soon as possible to make sure you understand what your coverage is.  

 
Give them the following CPT codes97802 and 97803.
Ask them the following questions: 
 
  • Are my diagnoses covered?  Is Z71.3 or Z72.4 a covered diagnosis?
  • Have I met my deductible?  Do I have a copay or coinsurance?  
  • Are there any limitations on the number of visits per year?  
  • Is a referral from a primary care provider or prior authorization required?  
  • Is Telehealth covered? Does this include phone consults?  
 
 
 

Thank you!

Contact:
Marybeth Judy MS, RDN, CSR, LD

PH: 207-752-2341
FAX: 855-752-0261
marybeth@thefearlessfork.com