BRG Dietetics & Nutrition, P.C.

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Check Your Insurance Company

Insurance companies are beginning to recognize the cost benefit of providing Medical Nutrition Therapy coverage. Some disease states that coverage is available for includes: diabetes, high blood pressure, elevated blood cholesterol or triglycerides, cardiovascular disease, irritable bowel syndrome, Crohn’s disease, kidney disease and high risk pregnancy. Other diagnoses may be covered as well, as long as Medical Nutrition Therapy is part of the treatment plan.

The following is a list of insurance companies in which Bonnie participates. For companies not listed, coverage may be provided if you have out of network benefits and Medical Nutrition Therapy is part of your benefits package.

Insurance Company	Provider Number	Services Available
Oxford Health Plans	P797526	Insured benefit for medical diagnosis and obesity; alternative medicine benefit for prevention
Cigna	8461009	In-network and out-of-network benefits available; depends on your specific plan
United Healthcare	1141750	Participates in the following plans: PPO Plans, Select HMO/Select Plus, Select EPO, Select Plus POS, Choice HMO, Choice Plus HMO, Choice EPO, Choice Plus POS, Choice Plus PPO; 20% discount available for other plans
Americhoice by United Healthcare	100114175001	Participates in the following plans: Child Health Plus, Family Health Plus, Medicaid
NYS Government Empire Plan	---------	Participates in Complementary and Alternative Medicine Plan; 25% discount
Vytra Health Plans	2142444	Participates in all plans
HIP	205253P	Participates in the following plans: HIP Access I HIP Access II HIP Choice Plus POS HIP Choice Plus Direct POS HIP Direct Pay POS HIP Healthy NY HIP Premium HMOs HIP Prime EPO HIP Prime POS HIP Prime PPO HIP Select EPO HIP Select PPO Medicare PPO
Empire Blue Cross/Blue Shield	S0178	For diabetes only, within New York State; Out-of-network benefits available; depends on your specific plan
Aetna	---------	Out-of-network benefits available; depends on your specific plan

Please note: It is possible that you are eligible for insurance coverage or an insurance discount, even if your insurance company is not listed above. Please use the form below so that we can confirm your insurance coverage.

Applications are currently being completed for the following insurance plans:
Horizon, Multiplan, Independent Health, MDNY, Guardian, Beech Street

For patients with Diabetes who reside in New York State…
There is a state mandate requiring some health insurance policies to reimburse for diabetes self-management education, equipment and supplies. It is possible that you are eligible for this coverage, even if Bonnie does not participate in your plan. For more information on the NYS mandate, click on www.diabetesmonitor.com/ny.htm. Call your insurance carrier to inquire about diabetes self-management education coverage.

There may be similar mandates in other states. Call your insurance company today.

Important: Even though Bonnie is a participating provider for the insurance companies listed above, you must check to see that YOUR individual plan covers Medical Nutrition Therapy.

If you would like us to check your personal health insurance information to see if Medical Nutrition Therapy is a covered benefit, please call us with the your insurance information, or use the form below to submit the information at least 72 hours ahead of your appointment.

Insurance Form: All fields are required for us to check your insurance.

Patient's Name:
Name of Insured:
Insured's relationship to Patient (if not same):
Your Email:
Your Phone Number:		()
Patient's Birthdate:
Birthdate of the Insured (if not same):
Subscriber or Member ID Number:
Group Number:
Health Insurance Company and Type of Insurance: (PPO, HMO, POS, etc.)
Toll-free Phone Number of Insurance Company:		()
Reason for Visit:
Home Zip Code:

Getting support from family and friends will make it easier to stay motivated and stick to your goals. Enlist a buddy to join you on the path to being healthier!

All recipes include diabetic exchanges and Nutrition Facts.

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