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Starting an insurance-based nutrition practice can feel way harder than anyone warned you it would be. If you’re a dietitian who just started accepting insurance and you’re thinking, “Why does this feel more complicated than patient care?” Congratulations, you’re normal. 

 

Today, I’m breaking down the most common mistakes new insurance dietitians make, not to shame you, but to save you time, money, and unnecessary spiraling. And if you’ve already made some of these mistakes? 

 

Same. That’s how I know.

 

Mistake #1: Thinking Credentialing Equals Contracting

This one trips up almost every new insurance dietitian. Credentialing feels like the finish line, but it’s actually just the warm-up lap. Credentialing means the insurance company acknowledges that you exist as a provider. Contracting is what determines whether they will actually pay you. Those are two distinct steps in the insurance credentialing process for dietitians, and conflating them can delay payment for months.

How to avoid it:

Always confirm that you have a signed contract and an effective date, not just a credentialing approval. If this feels confusing, it’s because no one explains insurance credentialing clearly — not because you’re doing something wrong.

 

 

 

 

Mistake #2: Trusting Insurance Benefits Like They’re a Promise

 

Insurance benefits are not a guarantee. They’re more like a suggestion… with fine print. Patients aren’t lying when they tell you what their insurance portal says; they’re just reading information written by lawyers, not claims processors. New insurance dietitians often assume benefits equal payment, which leads to unexpected denials and refunds.

 

How to avoid it:

Verify benefits like a professional, not like an optimist. Proper insurance verification is a critical skill for dietitians accepting insurance and can prevent major revenue issues later.

 

Need the exact script I use? Snag my Starter Pack of Forms HERE. 

 

Mistake #3: Writing Notes for Humans Instead of Insurance

You’re a caring clinician. Insurance does not care. Insurance companies want to see diagnosis codes, medical necessity, and documentation that can survive an audit — not whether your note felt therapeutic to write. Many insurance dietitians struggle here early on, and that’s normal.

Compassionate truth:

Documentation for insurance is a learned skill. You’re not bad at it, you’re just new. Learning how to write insurance-compliant notes is essential for successful insurance billing for dietitians.

Want to know how to document like a Rock Start? Snag my Master Class HERE. 

 

Mistake #4: Taking Claim Denials Personally

Claim denials feel personal, but they aren’t. Insurance companies deny claims the way spam filters block emails — aggressively and often incorrectly. New insurance dietitians often internalize denials as failure, when in reality, denials are part of the billing process.

How to avoid it:

A denial is not a moral judgment. It’s a puzzle to solve. Understanding insurance denials and appeals is essential to running an insurance-based nutrition practice.

 

Need help with master billing like a Ninja? Check out my services HERE. 

Mistake #5: Waiting Until You’re Drowning to Get Help

Most dietitians don’t ask for help with insurance until something is denied, refunded, or completely broken. But insurance is far easier to manage when you understand it before issues arise. Upfront support and education can prevent months of frustration later.

 

You don’t need to be perfect. But you DO need to be informed. Building a sustainable insurance-based practice for dietitians starts with understanding the system, not fighting it blindly.

 

If this post made you feel seen, you’re not alone. These mistakes are common, fixable, and part of the learning curve. With the proper guidance, accepting insurance doesn’t have to cost you your sanity.

 

 

Let’s be real—dietitians love to complain.

Some more than others.

Whether it’s our long, windy academic path, the perceived lack of respect for our profession, or the struggle for fair pay, dietitians often find themselves stuck in victim mode. And honestly, most don’t even realize it.

If you’re an insurance-based dietitian, you’ve probably heard—or said—things like:

• “Insurance doesn’t work for me.”
• “Should I report this to the insurance commissioner?”
• “How am I supposed to grow when three other dietitians are in my town?”

   

I hear this sh*t constantly.

As an insurance-based dietitian who built a thriving practice long before it was the norm—and continues to scale sustainably—I’m over the complaining. 

I’m tired of the victim mindset. 

The truth is, you can build a wildly successful nutrition practice that accepts insurance. But it requires grit, courage, and ACTION.

 

The Private Practice Game Isn’t Zero-Sum

Here’s the thing: private practice isn’t a zero-sum game. I don’t have to lose for you to win. We can all succeed. There are more than enough people who need our help.

My hybrid insurance-based group practice sees over 500 patients a month. I live in Connecticut, where my town has at least seven other insurance-based dietitians. We all coexist—and thrive. Collaboration will always get you further than competition.

Stop going to battle with your team.

 

 

“Should” is the Root of All Pain

• “It should be busier.”

   

• “The Academy should be doing more.”

   

• “Insurance companies should teach us how to bill.”

   

We’ve all had those thoughts. But the word “should” won’t move your practice forward. Venting on Facebook threads won’t build your business. Wishing things were different won’t change the reality.

Want to succeed as an insurance-based dietitian? Focus on what you can control and take bold, consistent action.

 

Growth Comes from the Suck

I didn’t become good at running an insurance-based practice overnight. I sucked. I failed—over and over. I made every mistake in the book (some of them twice). But I kept going.

Every struggle was a rep that made me stronger.

So when things go wrong in your practice, stop assuming it means you’re not cut out for this. 

Problems are just growth opportunities in disguise. 

Running a business isn’t binary—it’s not pass or fail. It’s a skillset you develop through repetition and experience.

 

Your Success is Built in the Hard Moments

Each level of business will test you. 

You’ll feel overwhelmed. 

You’ll want to quit. 

But that’s where fundamental transformation happens.

As an insurance-based dietitian, your journey will never be linear. But if you can embrace the discomfort, let go of the victim narrative, and lean into action, you’ll build a practice that supports you and creates massive impact.

As usual, take THIS blog as a love letter to myself. We ALL need a good kick in the pants now and again. 

I am cheering for you! 

 

 

It’s your girl, Amy P.—The Reimbursement Dietitian, and my mission is to simplify the wild world of insurance reimbursement for dietitians and CNSs everywhere.

 

Today, we’re talking about one of the most important (and often overlooked) parts of getting paid: your EFT setup.

 

Because here’s the truth—if your insurance payments never seem to hit your bank account, your Electronic Funds Transfer (EFT) might be the silent saboteur.

 

Let’s break down the three biggest EFT mistakes dietitians make—and how to fix them before your next reimbursement cycle.

 

Mistake #1: Not Knowing You Even Need to Set Up EFTs

You’d be shocked at how many dietitians assume that once they’re credentialed and start billing, the payments will magically appear in their accounts.

 

Spoiler alert: they won’t.

 

Each payer requires a separate EFT enrollment form, and if you skip this step, you’ll be waiting on paper checks (and yes, actual snail mail delays).

 

Some payers even send payments via V-Cards, which function like credit cards—but here’s the kicker: your processor (Square, Stripe, Stax, etc.) will take a cut in processing fees.

 

So please—don’t sleep on your EFT setup.

 

Make sure you enroll with every payer and always link it to your business checking account, not your personal one.

 

 

Mistake #2: Not Verifying Your EFT Enrollment

Submitting your EFT form isn’t the finish line—it’s just step one.

 

Most insurance payers require a verification step, sometimes referred to as a “test deposit” or “pre-note,” before live payments begin.

 

If you skip this, your claims can sit in limbo, get rejected, or even get rerouted to paper checks.

And trust me—waiting on those is no bueno.

 

Always confirm that your EFT enrollment is active by logging into your payer portal or calling provider services.

 

Mistake #3: Forgetting to Update Your EFT Info

 

Did you change banks, switch your business entity, or even update your name?

If so, your EFT information needs to be updated everywhere—or your payments could end up in the wrong place.

 

Even worse, some payers (like Medicare) won’t accept online-only banks.

 

They require a financial institution with a physical branch (think Chase, Wells Fargo, or Bank of America).

 

Amy P. Pro Tip: Set up a simple audit system to review your EFT details every 6–12 months or whenever you make changes to your business banking. A quick check can save you weeks of payment headaches.

 

Bottom Line

EFT errors are one of the easiest ways to mess up your cash flow—but the good news? They’re also one of the easiest to fix once you know what to look for.

 

If all this EFT, billing, and credentialing stuff makes your head spin, that’s precisely what my Reimbursement Coaching Program is for.

 

You’ll get step-by-step support on EFT setup, insurance credentialing, billing, and all the moving parts of reimbursement—so you can stop chasing payments and start getting paid what you deserve.

 

👉 Apply to The Reimbursement Dietitian’s Coaching Program here, yo! 

 

 

It’s Amy P., The Reimbursement Dietitian, here to drop some truth: insurance isn’t the enemy—it’s your shortcut from side hustle mode to a six-figure insurance-based private practice.

After billing insurance since 2007, I’ve seen dietitians miss out on serious revenue because of fear, confusion, and lack of clarity. 

Stop blaming insurance—it’s an untapped opportunity waiting to pay YOU.

Pro Tip: If you’re new here, check out my Guide to Starting an Insurance-Based Practice to get the foundation before diving in.

 

 

Why Insurance Isn’t Scary for Dietitians

Most RDs hear “insurance” and think:

❌ Confusing AF
❌ Bureaucracy hell
❌ Soul-sucking headache

Here’s the tea: it’s not insurance. The real problem is not understanding insurance billing for dietitians. 

Claims denied? Payments delayed? Blaming Blue Cross won’t fix the knowledge gap.

The secret: Learn the rules, understand CPT codes, ICD-10 codes, preventive vs. medical MNT, and benefit verification—and insurance stops being scary.

Resource: Check out my Billing Cheat Sheet to level up your coding game.

 

 

What’s Possible When You Leverage Insurance

Imagine this:

✔ A manageable schedule
✔ Consistent payments—no more hoping clients Venmo you
✔ Patients can come as often as needed without stressing their wallets
✔ Scale your practice without burning out

While cash-based RDs hustle for random clients, you’re building a system that pays while you sleep.

💥 Insurance lets you work smarter, not harder. But let’s be real—you need to see patients 1:1. Two clients a week? Dreaming. Side hustle fantasies won’t make six figures.

Pro Tip: Learn how to maximize insurance reimbursements without losing your sanity.

 

Reframe Your Mindset: Stop Fear-Mongering

Success isn’t about knowing everything from day one.

It’s about:
✅ Seeing what’s possible
✅ Investing in yourself
✅ Taking action

Think of a practice that actually pays YOU for your expertise. Insurance lets you serve more clients, increase your impact, and finally see your value reflected in your bank account.

Related Video: Top Three Mistakes to Avoid in Your Insurance-Based Practice

Take Action: Grow Your Insurance-Based Practice

Remember:

• Insurance isn’t your enemy
• Fear is just an untapped opportunity
• You already have the skills to grow, scale, and make bank.

   

Ready to stop guessing and start seeing results? Check out my free YouTube resources on insurance billing for dietitians.

And if you want a step-by-step system to turn insurance into your six-figure shortcut, my Reimbursement Coaching Program will take you there.

💥 You’re skilled. You’re capable. Time to get paid like the boss RD you are.

Click here to learn more and apply!

 

 

It’s your girl, Amy P., The Reimbursement Dietitian, and you know my mission — to make the reimbursement process for dietitians and CNSs simple, profitable, and repeatable.

 

day, we’re diving into a question I get all the time:

 

“How much do dietitians actually make with insurance?”

 

 

You’ve probably heard the hype: 💰 “You can make $100/hour as a dietitian!”

 

 

Heck, I’ve said it too — because it’s technically accurate. If you’re credentialed with insurance, many commercial payers reimburse $100/hour or more. A sh*t ton more. Oregon, I am looking at you. 

 

 

But here’s the part most people don’t talk about…

 

 

Just because you make $100/hour doesn’t mean you keep $100/hour.

 

 

Let’s break down what that really looks like in a private practice that accepts insurance.

 

 

The Real Story Behind $100/hour

So you’re bringing home $100 per session. Sounds amazing, right?

 

 

But here’s where the hourly rate for insurance-based dietitians gets real:

 

 

After you factor in:

• Federal & state taxes
  
• Business software and EHR subscriptions
  
• Admin hours (follow-ups, scheduling, forms)
  
• Documentation time
  
• Credentialing and billing fees
  
• Time spent working without getting paid (emails, client prep, team meetings…)

   

You’re looking at closer to $60/hour in actual take-home pay. Not that is ‘bad’ by any means. It is just the truth of how business works. 

 

 

 

Why This Still Isn’t Bad News

This isn’t meant to scare you — it’s to help you be smart. If you’re wondering how much dietitians make with insurance, the key is to look at net income, not just gross.

 

👉 Smart RDs track expenses
👉 Smart RDs optimize their admin time
👉 Smart RDs build systems that scale

 

Because what matters most isn’t just what you bill — it’s what you keep.

 

 

Want to Build a Profitable, Sustainable Practice?

 

If you’re ready to start or grow an insurance-based practice that pays you well and keeps your sanity intact…

 

 

My coaching program teaches you:

 

 

• How to get credentialed fast
  
• How to bill clean claims and get paid
  
• How to grow without burning out

   

   

👉 Apply here to learn more. 

 

When a Client Wants Their Records: What the HIPAA Rule Actually Says

If you’ve ever had a client email you asking for “everything in their chart,” you’re not alone. It’s becoming more common as clients (and insurance companies) get savvier about their rights. 

 

But what are you actually required to share under HIPAA?

 

Under the HIPAA Privacy Rule, clients and their legal representatives have the right to inspect and obtain a copy of their records. 

 

That includes anything you use to make decisions about their care. You must provide the records within 30 days of the request; however, you may request an additional 30 days if you provide written notice explaining the delay.

 

Clients can request records in paper or electronic form, depending on what’s feasible for your practice. 

 

And no, you can’t deny access just because you’re worried they might disagree with your notes or misinterpret your recommendations. (Yes, even if you know they’ll take that “reduce sodium” note personally.)

 

 

What Counts as the “Designated Record Set”

Here’s where most dietitians get tripped up: not everything in your EMR is considered part of the “designated record set.”

 

You are required to share any documentation that informs decisions about the client’s care, such as:

• Initial and follow-up MNT session notes
  
  
• Nutrition assessments, care plans, and goals
  
  
• Correspondence with other providers (if it influenced care)
  
  
• Lab interpretations or summaries used in your recommendations
  
  
• Progress tracking or SMART goal documentation
  
  

What you don’t have to provide:

• Administrative paperwork (like scheduling notes or billing records)
  
  
• Personal reminders or draft notes are intended solely for your use.
  
  
• Copyrighted or generic educational handouts (though including them can show transparency)
  
  

This distinction is particularly important when handling MNT insurance denials. If a payer ever audits your documentation or a client requests records after a denied claim, you want your “designated record set” to be clear, compliant, and professional.

 

 

Do You Have to Include Handouts or Educational Materials?

If the handouts you provided were specific to the client’s plan of care—say, a customized carbohydrate-counting guide—it’s good practice to include them in the record release. However, HIPAA doesn’t require it.

 

Generic materials like “High Fiber Food List” or “Healthy Plate Visuals” don’t count as part of the legal record. That said, many dietitians still choose to include them for context or as a gesture of goodwill.

 

Can You Charge a Fee for Record Requests?

 

Yes, but only within reason. 

 

HIPAA allows you to charge a cost-based fee that reflects your actual expense in preparing and delivering the records. 

 

This can include:

• Labor for copying or scanning
  
  
• Postage (if mailed)
  
  
• The cost of a USB or CD (if applicable)
  
  

 

What’s not allowed? “Retrieval,” “review,” or “administrative” fees.

                 

Most dietitians charge between $ 10 and $30 for lengthy or complex record requests, although many waive the fee for electronic copies or short records.

 

 

How to Handle Record Requests Like a Pro

 

Having a clear process saves you from stress when these requests pop up, especially if they’re linked to MNT insurance denials or disputed claims. 

 

Here’s your quick checklist:

1. Have a written policy in your HIPAA Notice of Privacy Practices that outlines how clients can request their records.
   
   
2. Use a formal record request form noting the date, scope (e.g., “all MNT records from 2023–2024”), and format (PDF, portal, printed).
   
   
3. Redact any third-party identifiers, for example, if your notes mention a family member or another client.
   
   
4. Deliver records securely via encrypted email, patient portal, or secure mail.
   
   

 

Keep documentation of what was sent and when.

 

 

Don’t Forget State Law

HIPAA sets the baseline, but your state law may be stricter. 

 

Some states require you to fulfill requests faster (within 15 days) or limit what you can charge. Always check your state’s health record access laws to stay compliant.

 

The Bottom Line

When clients request their nutrition records, it’s not a personal matter; it’s their right. 

 

As a provider, it’s your responsibility to handle the request confidently, professionally, and in accordance with the law.

 

And if your record-keeping ever comes into play during an MNT insurance denial, having organized, compliant documentation can protect your practice and your reputation.

 

HIPAA isn’t here to trip you up; it’s here to remind you that good documentation is good business.