Decoding Dietitian Billing: Part 2 - Contracting

Hi Reader,

Last month we tackled Phase 1 of the reimbursement journey: Credentialing. Now it’s time to seal the deal with Phase 2: Contracting.

Before you spend hours filling out applications for major commercial payers, I want to share my top recommendation: Obtain your Medicare & Medicaid IDs first.

Why? Because when you start applying, you will run into “Closed Networks.” A Closed Network (or Closed Panel) is a status indicating that an insurance payer is currently not accepting new providers for a specific specialty and geographic region.

However, even if a major commercial panel is closed, it might still be open for Medicare or Medicaid providers! Securing those IDs first can be your golden ticket inside.

Health insurance markets are highly localized and often concentrated, meaning a few insurers may dominate your specific area. Knowing who to target and how to apply (hint: it’s often a 15-minute online form now!) saves you massive headaches.

August Blog

Decoding Dietitian Billing – The 3 C’s to Reimbursement; Part 2: Contracting

In this month’s blog post, we break down exactly how to navigate Contracting, including:

1. The Medicare/Medicaid strategy.
2. Why Self-Funded employer plans can add or completely remove your MNT services.
3. How to find out who the market leaders are in your area using an awesome interactive tool!

Prefer to watch instead?

📺Video of the Month

I just dropped a brand new YouTube video breaking down these strategies! In just 7 minutes, we cover the critical difference between being credentialed and contracted, and exactly how to use a Letter of Intent (LOI) to bust open a closed panel.

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🛠Resource of the Month:

Stop guessing which payers are dominant in your area! Research which insurers hold the most power in your Metropolitan Statistical Area (MSA) by using the KFF Market Share Interactive Tool where you will learn the top 3 payers in your state.

📋 Term of the Month from “The Dietitian’s Insurance Cheat Sheet”

Still haven’t grabbed the Cheat Sheet?

Learn more about becoming an Insurance-Ready Dietitian at my website.

See You Next Month...🔮

Coming Up in September: Decoding Dietitian Billing – Part 3: Coding, Billing & Claims (Getting Paid)

You did it. You navigated the credentialing maze and finally signed your contract. Now comes the part where your hard work actually turns into a paycheck!

Welcome to Phase 3: Coding, Billing & Claims.

Let’s be honest: trying to decipher billing requirements often feels like trying to translate a completely foreign language. Staring down a CMS-1500 claim form or trying to figure out CPT codes can make even the most confident dietitian break into a cold sweat.

You just want to help your patients, but instead, you're stuck worrying whether a simple formatting error will result in a denied claim. We know how incredibly frustrating it is to feel like you're one typo away from working for free.

After helping countless dietitians navigate this exact same alphabet soup, we've figured out a better way. You don't need to be a professional medical coder to get paid.

Next month, we are wrapping up our Three C's series by breaking down:

• How to submit clean claims on the first try.
• The essential CPT codes, modifiers, and diagnosis rules every dietitian needs.
• The step-by-step secret to turning claims into actual direct deposits.

Until then, keep your Insurance Cheat Sheet bookmarked, and stay tuned!

To your success,

Laura