Common Insurance Questions and Answers

We know that accepting insurance on behalf of your clients is a big step! But once you get familiar with the system, you’ll feel like a pro. Or – don’t worry about navigating the system, and leave the work to the Healthy Bytes billing allies. To get you started, we are answering a few common questions that we hear from you via email, phone and when we chat with you in person at conferences. We want to help you feel more comfortable with the insurance lingo and landscape.

What is an NPI number? What is the difference between a Type I NPI and a Type II NPI?

HIPAA regulations dictate that, as a health care provider working with health insurance companies, you need a National Provider Identifier (NPI) number. These 10-digit numbers are a way for the healthcare sector to identify health professionals consistently, and they are publicly searchable.

There are actually two types of NPIs, referred to as “Type I” and, yes, “Type II.” Type I NPIs are also sometimes called individual or personal NPIs, while Type II NPIs can be called either organizational or group NPIs. Essentially, if you have a private practice, to file claims with health insurance companies, you'll only need a Type I NPI.

How do I bill for a group visit? What is the minimum number of clients needed to constitute a group visit?

Answer: You can bill your group visit using CPT code 97804 – this is for a Medical Nutrition Therapy (MNT) Group Visit, which are billed in 30-minute increments. Two or more clients are needed to partake in the group session. Some insurance companies may only cover up to a certain number of clients in a particular group session; we have seen this vary by insurance company.

Am I able to provide telehealth services across state lines?

This is a great question. Please give us a call to discuss this with you prior to launching this service—we’re eager to help clarify your state’s regulations! 

Currently, laws and licensing for RDNs in various states can restrict you from openly practicing telehealth across state lines. Fortunately, we’ve learned recently that the Academy of Nutrition and Dietetics is beginning a review of the “…practicability and implications of pursuing enactment of a Registered Dietitian Nutritionist Compact that would enable RDNs and other qualified licensed dietitians to practice in multiple states under a single license.” Cheers to that! 

Other healthcare practitioners have more easily been able to incorporate telemedicine into their practices, but RDNs face challenges in overcoming barriers to entry, namely due to the lack of seamless state licensure laws. 

How Do I Seek and Secure Physician Referrals?

Networking with physicians is a solid means of ultimately bringing clients through your door. First, do your research. Make a list of local contacts that could potentially send clients to your private practice. Your list might turn up a few or a few thousand, depending on where you live! Start small – perhaps you outreach to a couple clinics per week or per month, depending on your capacity.

Second, be strategic. Do you have a niche in providing care for patients with Celiac? Target your search on healthcare providers who are GI specialists. You see that clinic A has five doctors on staff who focus on GI care. Great find! Which insurance companies are you contracted with? Reach out to providers who are also under that insurance plan.

Then, say hello! Prep a letter or email that shares how you would like to refer patients to them. Suggest that you become referral partners and outline how your joint clients would benefit. Briefly describe your niche and impressive skillset. Attach or enclose a referral form to make it a no-brainer for them!

What questions do you have about accepting health insurance on behalf of your clients? Share them below!