How to refer a patient

Fax:  Please send the client’s most recent progress note, pertinent labs, H&P, and other supporting documents to (833) 291-4244. Be sure to include the nutrition related ICD-10 diagnostic code related to the reason for referral. If you are unsure, you can always use the preventative code Z71.3 Dietary Surveillance and Counseling. For your convenience you can print our Medical Nutrition Therapy Referral Form, however this is not required. Once we receive your fax, we will contact the patient to schedule and notify you of the scheduled appointment.

Phone:  You can call us at 937-371-3450 and provide the necessary information over the phone or you can have your patient contact me directly.  For insurance reimbursement, it is helpful to have your most recent progress notes and any related nutrition diagnosis.  This isn’t required, but may help with reimbursement.  Please see above for instructions on faxing documents.

FAQs

Do you take insurance? We are in-network with Anthem BCBS, Cigna, Medical Mutual of Ohio and United Health Care. We are also able to accept HSA/FSA cards and all major credit cards. If your patient would like to submit their bill for reimbursement, we will generate a Superbill upon request. Some patients receive up to 100% reimbursement for their appointment, while some patients solely have the payment applied towards their deductible. Due to the wide variety in policies, reimbursement will depend on your patient’s specific policy.