Insurance, Self-Pay Options & FAQ

Insurance, Self-Pay Options & FAQ

Your health insurance may cover the entire cost for your nutrition counseling. We may be able to look into your benefits for you, or you can check with your insurance provider. Ultimately, it is your responsibility to know and understand their own benefits.  

EVOLUTION accepts the following Health Insurances:

Insurance Information

Referrals are preferred by our practice as we need proof of diagnosis.  So even if your insurance company doesn’t require a referral, we may.  It would be in your best interest to call your doctor’s office and ask them to fax a referral for nutrition counseling to 401-396-9369.

Rhode Island

  • Diagnosis is required.
  • Referral is not required. 
  • Most plans cover unlimited visits. 
  • If your subscriber ID starts with a ‘PVC’ a copay and 6 visit limit could apply.

Out of State 

  • Diagnosis is required.
  • Referral is not required. 
  • We can take any BCBS PPO from any state.
  • The coverage varies greatly, and we cannot guarantee coverage or if a diagnosis is required. A copay or deductible may apply. 
    • It is in your best interest to call your insurance plan and ask for nutrition counseling benefits. 
  • If your subscriber ID starts with a ‘BOU’ or ‘MGE’ your plan covers in full with no copay or deductible

Federal BCBS (FEP)

  • Diagnosis is not required.
  • Referral is not required. 
  • Blue Cross Blue Shield’s Federal Employee Program (FEP) covers unlimited nutrition visits.

United 

  • Diagnosis is required.
  • Referral is not required. 
  • Coverage varies per plan. Some plans cover in full, some with a copay or a deductible, while others may be an exclusion on the policy. 
    • It is in your best interest to call your insurance plan and ask for your nutrition counseling benefits.
  • The number of visits varies per plan. 

United Ritecare 

  • Diagnosis is required.
  • Referral is not required. 
  • Covers in full, unlimited visits. 
  • Diagnosis is required. 
    • Diagnosis must be diabetes or chronic kidney disease (not on dialysis).  NO OTHER DIAGNOSIS ARE COVERED FOR THESE PLANS.
  • Referral is required. 
  • No copays or deductibles.

Tufts

  • Diagnosis is required.
  • Referral may be required. 
  • If you have an HMO you will need to have a referral from your primary care physician on file. (This primary care must be the same one listed on your policy).
  • CareLink and PPO will not require a doctor’s referral.
  • Your specialist copay may apply. 
  • Most plans cover unlimited visits.

Tufts RI Together (Medicaid)

  • Diagnosis is required.
  • Referral is not required. 
  • Covers in full, unlimited visits. 
  • Diagnosis is required.
  • Referral is not required. 
  • Your specialist copay or a deductible may apply. 
  • 3 visits per year allowed.
  • Diagnosis is required.
  • Referral is not required. 
  • Your specialist copay or a deductible may apply. 
  • Aetna will typically cover 26 visits per year.
  • Diagnosis is required.
  • Referral is not required. 
  • Your specialist copay or a deductible may apply.
  • Visit limitations may vary per plan.
  • Diagnosis is required.
  • Referral is not required. 
  • Covers in full, unlimited visits.
  • Diagnosis is required. 
    • Diagnosis must be diabetes or chronic kidney disease (not on dialysis).  NO OTHER DIAGNOSIS ARE COVERED FOR MEDICARE.
  • Referral is required. 
  • No copays or deductibles.

Not accepted

Not accepted

Not accepted

Not accepted

Frequently Asked Questions

This is standard office procedures to fill out office forms before being seen in any medical office.  Doing these forms electronically saves paper and streamlines the process.  If you would prefer to fill out the form in our office, or have the form mailed to you and can mail back please call us at 401-396-9331 and request this. 

Your first appointment is 60-75 minutes.  During this time, you will work 1:1 with your dietitian.  Your dietitian will gather information to get to understand your intentions for meeting, and learn more about your life, history and daily eating patterns in order to best support you.  This is a collaborative experience, and all recommendations are unique to help meet the needs and desires of the patient.  Once your appointment is over you will work to book a follow up appointment.  

Our dietitians often do not hand out generic meal plans.  They are often not useful for long term, sustainable changes.  Of course, there are always special circumstances in which a meal plan would be warranted, but this isn’t usually a first step when working with our dietitians. 

We do have a cancellation policy.  Since many patients wait several weeks for their appointments, we appreciate that you understand as patients that wish to be seen sooner benefit from this policy.  Canceling with less than 24 hours’ notice or no showing your appointment will result in being charged a $25 fee.  

Self-pay prices are $125 for an initial appointment and $60 for follow-ups.  For follow up you can also purchase a package of 5 visits for $250.

All of the dietitians at EVOLUTION Nutrition practice from a weight inclusive perspective.  Our dietitians can help patients with improved eating habits, nutrition education, navigating medical conditions as they relate to nutrition, relationship with food and body, overall lifestyle habits, but we cannot help with intentional weight loss. Most times people may be able to lose weight in the short term but cannot sustain it and often become obsessed and end up yo-yoing their weight in the end. This cycle often leads to worsening physical and mental outcomes.  Please be aware of this before requesting an appointment. 

Abnormal Weight Loss or Weight GainDyspepsia
Hypoglycemia
AnemiaFamily History of Cardiovascular Disease
Hypothyroidism
Anorexia NervosaFamily History of Diabetes
Impaired Fasting Glucose
ARFIDEating Disorder
Irritable Bowel Syndrome
Binge Eating DisorderEosinophilic Esophagitis (EOE)
Lactose Intolerance
Bulimia NervosaFailure to Thrive (FTT), Child
Non-Alcoholic Fatty Liver Disease
Celiac DiseaseFPIES
Other Issues Concerning Food & Fluid Intake
Change in Bowel HabitsFood AllergyPrediabetes
ConstipationGastritisPCOS
Crohn’s DiseaseGastroesophageal Reflux Disease (GERD)
Small Intestinal Bacterial Overgrowth (SIBO)
Diabetes, Type 1GastroparesisTube Feeding
Diabetes, Type 2High-Blood Pressure
Ulcerative Colitis
DiarrheaHyperlipidemia
Vitamin D Deficiency
Diverticular DiseaseHypertension
Weight Concern

Yes

what to ask your insurance

If your insurance company is found in the above list, this means we are participating with your plan. We are happy to submit the claims for your visits; however, you should be aware that benefits for nutritional counseling can vary greatly among individuals. Not all policies contain benefits for nutritional counseling. Here you will find a list of questions that will help you when speaking to your insurance company.

1. Do my benefits include nutritional counseling? (Procedure codes 97802, 97803)
2. Are there any exclusions or limitations (such as limit to number of visits)?
3. Are my visits subject to a deductible?
4. Am I responsible for any copay or coinsurance for the visit?