Denied Insurance Coverage For Dietician

[CeliacChild]

My insurance has denied coverage for a visit to the dietician after my daughter was diagnosed with Celiac Sprue. Has anyone been able to get their insurance to cover this? If so can you share the letter with me? I need help writing a letter to the board to request they review the denial.

Thanks

[*lee-lee*]

my insurance company denied me too. it was $200 out of pocket for an hour consult - no thanks. my GI actually said it wouldn't really be worth it to go anyhow.

i can't help with a letter but maybe the doctor that diagnosed your daughter can? you can also find tons of great info on this board...

[Gemini]

My insurance has denied coverage for a visit to the dietician after my daughter was diagnosed with Celiac Sprue. Has anyone been able to get their insurance to cover this? If so can you share the letter with me? I need help writing a letter to the board to request they review the denial.

Thanks

I have no idea what your financial situation is but if you really feel the need to see a dietician, it's money well spent. Having said that, I think if you went out and bought a couple of good books on Celiac Disease, you would learn far more than just sitting there, listening to a dietician who may or may not know anything about celiac disease. Nutritionists and dieticians are not always up to date on every medical condition that requires a dietary change. I never saw one but bought the books and found I didn't need to see one.

There are some excellent ones that focus on kids, specifically by Dana Korn, that would be very helpful to you! Good luck.

[sbj]

And if you don't feel like spending money on books just try your library! I found a ton of books at my main branch and even at the smaller local branches.

I found the dietician to be quite helpful but I would speak to him/her BEFORE your appointment to make sure they are prepared. I found mine to be helpful but there is no way that I would have spent $200 out of pocket. It wasn't worth $200.

It's a pity that your insco denied coverage. I can think of two things: (1) ask them if someone with diabetes would be covered to see a dietician. (2) Let them know that other insurers routinely provide this coverage. I am with Kaiser Permanente - they not only provide this coverage but this is considered preventive medicine and is cost-effective for the insurer.

The below link has some interesting coverage about insurance and denial.

Open Original Shared Link

Coverage for dietitian visits: In the U.S., insurance coverage for dietitian visits is mandated by law. Currently the law allows coverage for only a few types of dietitian visits, including coverage for transplant patients and people with type 1 diabetes. Celiac disease is not covered, so any time a newly diagnosed celiac wants to learn about the gluten-free diet from a dietitian, that individual will need to pay out of pocket. ... There is a place for you to turn if you have questions or concerns about insurance issues. The Patient Advocacy Foundation, located in Virginia, helps people with chronic and life-threatening health conditions to sort out their insurance issues. They are a non-profit agency, and they can be found on the web at

www.patientadvocate.org or at the following toll-free number: 800-532-5274.

[neesee]

Try your local health department for help. That's who helped me the most. They hooked me up with the GIG and sent me a lot if information about the diet. Of course that was before the internet!

I really didn't learn a darn thing from the dietician anyhow. I was covered 21 years ago, but I wouldn't be now. I was in the hospital though.

neesee

[mommida]

Almost five years ago, we had an appointment with the dietician.

She called and cancelled the appointment. Her advice was by Dana Korn's book Celiac Kids and come to this website.

The book is helpful and I've learned everything we needed to know from this site. You can't get better advice on a subject than direct contact with people that live gluten free 24/7.

[Gemini]

And if you don't feel like spending money on books just try your library! I found a ton of books at my main branch and even at the smaller local branches.

The only drawback to using the library is they don't let you keep the books very long and most newbies will absolutely be using the books for reference for at least 6 months. They are invaluable to own, at least in the beginning. These books do not cost much, I think I spent about $30.00 on 2 of them total and that's not a budget buster. Amazon has good prices on many Celiac related books.

The other important thing to do is buy or borrow a copy of Dr. Peter Green's book, "Celiac Disease: The Hidden Epidemic." It has good information on how to manage this disease the correct way and dispels the false information that is prevalent on the internet. It's important to get it right in the beginning so adapting will be easier. It really isn't as hard as it seems. It's just overwhelming at first but that will change with knowledge. You have to do a little studying in the beginning but it's worth the effort. I can imagine how difficult it must have been years ago but there is so much information out there and good books on the subject, you really can do this on your own, once diagnosed.

[Dyan]

I haven't tried going through my insurance, but I met with the one at the celiac disease conference in May. And all I can say is, I'm glad I didn't have to pay for that meeting. She just told me to let my daughter eat nachos and and to buy greek style yogurt. I would suggest eating well but still add a multivitamin.

[cmom]

My 2 dietician appointments were totally useless. She told me that I could eat Rice Krispies and when I asked her about the fact that it contained barley malt (and this was after being newly diagnosed), she said she really didn't know. I have found out much more helpful info on the forums and through my own research. Doctors haven't been much help either when it comes to the diet.

[debmidge]

My insurance has denied coverage for a visit to the dietician after my daughter was diagnosed with Celiac Sprue. Has anyone been able to get their insurance to cover this? If so can you share the letter with me? I need help writing a letter to the board to request they review the denial.

Thanks

We did the same thing - went thru the trouble of writing letter to insurance company and got "permisson" to see dietician. The visit was a waste of time. This forum and celiac.com and the celiac organizations provided much more information than the dietician did. Had I known I

would not have wasted the time and effort.

[Vamonos]

My insurance has denied coverage for a visit to the dietician after my daughter was diagnosed with Celiac Sprue. Has anyone been able to get their insurance to cover this? If so can you share the letter with me? I need help writing a letter to the board to request they review the denial.

Thanks

Your insurance company will have an appeal process. Call the customer service number to find out how you file an appeal. Upon review by the medical director, (who is a physician and not a claims adjuster) will know that the only treatment for Celiac is dietary modification-- your request for a nutrition consult should be approved. My own consult was initially denied, but was sent to medical review before I even knew it was denied and the medical director approved it immediately.

In the mean time, call the dietician and let her know you are appealing the denial. Do not pay the bill. Another way to insure that we, as Celiacs, get the coverage for medical care is to get the health care practitioners in your corner. If they are denied payment for their services they will become more proactive in making sure they are reimbursed by insurance for their time.

I hear what some of the other posters are saying in regard to the dietician not having much if any pertinent info regarding Celiac disease. By the time I got to see the person my doc referred me to I had already accumulated a file from great sites like this one. Another great source for information is your local library and it is FREE. The resource person will be happy to help you track down books on celiac and will obtain what ever you need from outside libraries if yours doesn't have what you are looking for.

You can do this. Your letter can be brief. The idea is to get it to the doctor's attention at the insurance company.

[Hummingbird4]

Mine was initially denied, and then I called them (Cigna) to explain that my doctor ordered me to see the dietician. It's not as if I went on my own for weight loss tips. They said, "Oh, okay, no problem. We'll pay it." I asked them if they needed a copy of the order from the doc and they said they didn't.

It was paid. (And like others have mentioned, the visit was completely useless and a waste of time. I found out MUCH more from this site than any dietician could have told me in an hour. Besides, her specialty was diabetes. She hardly knew anything about Celiac!)

[curiousgeorge]

Being in canada, dietician at the hospital was covered. I knew at least as much as she did just from reading on the net.

The ONLY useful thing she said was not to eat oatmeal for a year until the tummy heals which I suspect is really good advice. Other than that, she was nice but not particularly useful. I did however enjoy seeing the plastic veggies she had in serving size portions in her office. I realized I was eating way more servings of veggies than I realized.

[mamabear]

You might check the benefits for your particular plan. All plans are not equal. I also would advocate you push your insuror even if no dietician benefits exist. Our ONLY medicine is food, but I have yet to find a dietician who knows 10% of what you can find here!

[kbtoyssni]

If you do see a dietitian, I would recommend asking a few questions about his/her knowledge of celiac before making an appointment. There are some good ones out there, but most don't have a clue about what you can and cannot eat.

[debmidge]

If you do see a dietitian, I would recommend asking a few questions about his/her knowledge of celiac before making an appointment. There are some good ones out there, but most don't have a clue about what you can and cannot eat.

You're correct....but we did that. I had a conversation with her (dietitian/nutritionist) on the phone and she assured me she was knowledgeable because her sibling has celiac disease. Once we met with her,

however, it was clear to me that she only knew basics: don't eat gluten and read labels. The only GIG info she had was photocopied sheets of what not to eat and a photocopy of a magazine article. I feel at the least she should have had the CSA's Product handbook in her office, several books on celiac for example Bette Hagman books, etc. But she had none of this. She must never really talk or spend time with her celiac sibling....

[luvthelake21]

My DD was also denied coverage on dietitian services. Did not think at the time to see if would be covered to worried about her health than to call insurance company. When we met with her she did not help at all, told DD it would be ok to eat wheat b-day cake once a year and to take a small piece of the communion wafer at church I knew more about Celiac than she did. I had only studied for two weeks before meeting with her.

[Country Girl]

Our dietician visit was covered completely by United Health Care, and it was very valuable. I believe someone already told you to call and ask for a medical review by a physician. I would also call a rep at the company and let them know you will be filing an appeal through your state's Insurance commisioner and the office of the inspector general (both can be done online through your states website). This phrase usually gets me what I want.

[cat3883]

In my area the health food stores will have speakers. Usually they are dieticians and nutritionists. They are free or a very small fee. And my GI's office called me last week about a dietician they are having at his office after hours. The fee is $10. I am now meeting with a nutritionist that I met at one of the health food stores. She also has Celiac. She is teaching me many things. Check with the stores in your area. Good luck.

[ek327]

A knowledgeable dietician should not only be able to help you with what you can and can't eat, but what you should eat--to help with the history of malabsorption, and to find sources of micronutrients found in wheat, but not in rice, potato, tapioca starches/flours. There is much more to eating right for a person with celiac than to "not eat gluten".

[fran641]

My local hospital dietitian does not charge for visits to her. I would check with your local hospital about seeing their dietitian and if they charge.

She is a great lady but all the information she gave me was off the internet. If I did not have access or didn't use a computer the info she gave me would have been enough to get started. But I do need a book (or a few) to be able to look at often.