amyplano

 

Hey there, it’s Amy P., The Reimbursement Dietitian. This week, I want to share some real talk about a topic that makes most dietitians in private practice sweat: insurance audits.

 

You might think I’m immune to the stress of audits by now—trust me, I’m not. Even after going through this process many times, I still get that sinking-stomach feeling every time I receive the dreaded fax.

 

Most of our audits come from Anthem Blue Cross Blue Shield, and while I know they’re just doing their job, it never feels “easy.”

 

I’m writing this while we’re smack-dab in the middle of an audit—yes, one that landed during my vacation in Florida (because of course it did). So I thought now would be the perfect time to give you tips on handling insurance audits as a dietitian.

 

1. Know That Insurance Audits Are Inevitable (Not Punitive)

Insurance audits are part of doing business with insurance companies. They’re often random and used as part of internal checks and balances, not because you did anything wrong. The companies usually select a handful of patients at random.

 

 

2. What to Send in an Audit

They’re typically looking for:

• Your chart notes
  
  
• Any educational materials or resources you gave to patients (meal plans, handouts, etc.)
  
  
• Referrals (if applicable—but not always required)
  
  

Be sure your documentation is thorough and reflects the services provided. That’s your safety net.

 

3. Deadlines Are Tight—But Extensions Are Possible

You usually have 10–12 days to respond. However, in many cases, you can request a short extension. Don’t panic—just plan.

 

4. Don’t Freak Out—Most RDs Are Doing Just Fine

 

Many dietitians worry their notes won’t “pass.” But in my experience, most documentation is more than acceptable. If you’re unsure, I have a Documentation Master Class that explains precisely what to include to stay audit-ready.

 

5. Watch for Third-Party Requests

Medical record requests usually come from third-party companies like Inovalon or Ciox, not directly from the insurance company. Many RDs mistake these for scams, but they’re legit.

 

6. Submit Your Notes Safely

You can fax your notes or send them via a secure mail label provided by the audit company. Standard mail with a tracking label is often acceptable, and the company will typically cover shipping.

 

 

7. Expect a Mix of Patient Types

Auditors may request single-session notes, multi-session visits, or long-term patients seen weekly. That’s typical—don’t overthink it.

 

Bonus Resources

👉 Want help streamlining your charting process? Some coaching clients created a tutorial on using AI software like Heidi for easier documentation. Click [insert YouTube video on AI Charting] to check it out.

 

👉 Need help preparing for audits? I offer two Master Classes—one on documentation and one on insurance audits—where I show you what I’ve submitted and how the process works step-by-step.

 

 

Why 95% of Dietitians’ Insurance Problems Are Actually Their Fault

 

Let’s get real, RD fam—95% of the “insurance problems” you’re whining about?

 

Yep. They’re actually your fault.

 

Claims denied, money lost, screaming “insurance sucks”?

 

Not insurance—it’s a knowledge gap.

 

I’m Amy P., The Reimbursement Dietitian. I’ve been billing insurance since 2007, and I didn’t just learn this in a textbook. I broke it, fixed it, and now I teach dietitians like YOU how to do it without creating dumpster fires of confusion and lost money.

 

 

The Knowledge Gap That’s Costing You Money

Most dietitians know just enough to be dangerous. Winging it with CPT codes, ICD-10 codes, preventive vs medical MNT, and benefit verification isn’t cute—it’s expensive, confusing, and soul-sucking.

Go scroll a public FB billing group for dietitians: one RD says, “Always bill Z71.3,” another says, “Only medical codes,” and someone’s asking for help setting up EFTs. Fifty shades of… yeah, you get it.

 

 

Insurance Isn’t the Enemy – Confusion Is

Insurance isn’t scary—it’s an opportunity in disguise. The real problem? Fear and lack of clarity.

 

Preventive vs Medical MNT: Understanding the Difference

Many dietitians don’t know which MNT benefits to bill. Preventive? Medical? Each plan has quirks, and mistakes cost money.

How Benefit Verification Can Make or Break Your Claims

 

Checking eligibility and understanding a patient’s benefits isn’t glamorous, but it’s the difference between getting paid and crying into your leftover kale salad.

 

What’s Possible When You Master MNT Insurance Reimbursement

 

Imagine this:

 

✔ Your schedule is manageable.
✔ You’re not begging clients to Venmo you.
✔ Patients can come in as often as they need—and actually afford it.
✔ You scale your practice without burning out.

 

That’s insurance done right. While everyone else hustles for random cash-pay clients, you’re building a system that works while you sleep.

💥 Real talk: this isn’t magic. You will need to see patients, put in the work, and understand the codes. But unlike a cash-pay side hustle, insurance lets you make six figures without selling your soul. However, notice that ‘BUT’ is in caps – you need to work hard, see patients one-on-one, and experience a learning curve. I am not sugar coating THIS sh*t.

 

Stop Guessing – Build Structure and Clarity

 

What’s really holding dietitians back?

 

• Lack of structure
• Not knowing codes & benefits
• Chaos in your system.

 

The fix? Structure, clarity, and proper training.

 

Credentialing & Verifying Benefits

Knowing how to get credentialed with commercial insurance companies like BCBS, Cigna, Aetna, and UHC is your first step. Skip this, and you’re leaving money on the table.

EMR Mastery & Tracking Metrics

Once you understand billing and coding, track your results. Metrics help you grow without guesswork—and yes, more money rolls in.

 

How to Go From Confused → Confident → PAID

My Reimbursement Coaching Program walks dietitians from frustration to freedom.

 

You’ll learn:

✅ Credentialing & verifying insurance benefits
✅ Billing & coding like a pro for MNT
✅ Marketing your insurance-based practice without stress
✅ EMR mastery and tracking metrics for growth

 

Follow the system → grow your practice → help more patients → finally make the money you deserve.

 

Takeaway: Confusion Is Your Enemy, Not Insurance

Stop guessing.

 

Get structured.

Get paid.

Insurance isn’t the villain—your lack of clarity is.

When you master the rules, your patients love you, doctors respect you, and your checks (and EFTs) actually roll in.

💁‍♀️ Ready to turn insurance into your shortcut to six figures?

Check out my coaching program and start getting paid like the boss RD you are.

Click here to learn more & apply!

 

Billing Insurance as an Out-of-Network Dietitian: What You Need to Know About Superbills

Today’s hot topic: billing insurance as an out-of-network dietitian and how superbills come into play.

Superbills can be incredibly helpful for dietitians working with clients whose insurance plans you’re not credentialed with. 

But here’s the catch—they’re more complex than most RDs and CNSs realize.

The patient still needs to understand their out-of-network (OON) benefits, and even then, reimbursement is not guaranteed.

 

What Is a Superbill?

A superbill is a detailed document (like an invoice) outlining the services provided during a patient visit. 

It includes:

• Dates of service
• CPT codes for the services rendered
• ICD-10 diagnosis codes (if documented by a diagnosing provider)
• The fee charged for each service.

Patients can submit this form to their insurance company along with a claim form to get reimbursed for their nutrition services.

If you’re billing insurance as an out-of-network dietitian, the superbill is your client’s only tool to attempt reimbursement. You can’t submit claims for them—you’re out of network.

 

When Can You Provide a Superbill?

This is key.

 

You can only provide a superbill if you are truly out-of-network with the patient’s plan.

 

• ✅ You’re out-of-network → You can provide a superbill.
• ❌ You’re in-network → You must submit claims on the patient’s behalf.
• 🚫 You’re in-network, but their benefits are exhausted or not covered → There is no superbill because you’re still technically in-network, and the service isn’t reimbursable.

Note: Medicare doesn’t accept superbills, so skip it entirely with those patients.

Will the Patient Get Reimbursed?

 

The million-dollar question. And the answer?

 

It depends.

 

When billing insurance as an out-of-network dietitian, reimbursement is based entirely on the patient’s OON policy. 

 

Some plans have:

• High OON deductibles (mine is $8000!)
• Limited coverage
• No OON benefits at all

Insurance might reimburse them for sessions with you only after they meet their OON deductible and cost-sharing requirements.

 

What Diagnosis Codes (ICD-10) Can You Use?

 

Here’s a big mistake many dietitians make when creating superbills: using random ICD-10 codes without documentation.

We can’t diagnose. 

 

Even if we know the patient has diabetes or celiac, we can’t slap that on a superbill unless it’s been officially documented by a diagnosing provider.

 

To successfully navigate billing insurance as an out-of-network dietitian:

 

• Use diagnosis codes that are documented in the patient’s medical records.
• Know what codes are accepted by different plans.
• Understand how preventive vs. medical coverage affects reimbursement.

👉 Want help with this? Check out my ICD-10 Cheat Sheet here.

 

Final Thoughts

Providing superbills sounds simple, but it’s more nuanced than it looks. You can’t just toss “Z71.3” on every form and expect magic.

 

Reimbursement depends on what’s covered, the documentation, and how well the superbill is filled out.

 

So, if you’re committed to billing insurance as an out-of-network dietitian, ensure you’re doing it right, from coding to communicating expectations with patients.

 

Do you need a free PDF that explains how to fill out a superbill step by step?

 

Click HERE to grab it.

 

As always, I’m cheering for YOU!

 

 

A while back, I heard something on a podcast that stopped me in my tracks—the concept of a “pirate versus a practitioner.”

 

And honestly? It hit hard.

 

Especially in the world of RD business coaches, this comparison couldn’t be more accurate.

 

When building a successful private practice, I’ve come to realize that dietitian business coaches typically fall into one of two camps: the Pirate or the Practitioner.

 

The Pirate Dietitian Coach

The pirate dietitian coach is all about quick wins and shortcuts. They’re often focused on scaling fast, avoiding the messy realities of insurance, and chasing revenue at all costs.

 

You might recognize them because they:

 

• Avoid insurance and push cash-pay models exclusively
  
• Teach tactics that rely on workarounds or risky “hacks”
  
• Haven’t run a practice in years (if ever)
  
• Overpromise but rarely deliver sustainable results
  
  

These coaches often lean heavily on sales psychology, not systems.

 

And while their approach might deliver quick wins, it’s not built for the long haul.

 

It’s also not built on actual experience in today’s private practice world.

 

 

The Practitioner Dietitian Coach with Real-World Experience

Now let’s talk about the practitioner—the dietitian coach with real-world experience.

 

This coach doesn’t just teach from theory—they’re in the trenches right alongside their clients.

 

Here’s what makes them different:

 

• They actively run a private practice and see patients
  
• They are credentialed and bill insurance weekly
  
• They maintain credentials like CDCES
  
• They understand today’s challenges with EMRs, MD referrals, and compliance
  
• They build strategies around what’s working right now
  
  

This kind of coach doesn’t rely on outdated methods or hypothetical advice.

 

They practice what they preach—literally.

 

They know how to scale a sustainable, ethical business because they’re doing it themselves.

 

And yes, it takes more time, more effort, and more patience—but the result is a resilient, regulation-compliant practice that grows with purpose and longevity.

Why This Matters for You

 

If you’re building a practice that’s designed to last, you don’t want fluff.

 

You want proven systems, ethical guidance, and someone who truly gets it.

 

You need a dietitian coach with real-world experience—not one who’s been out of the game for years or never even played it.

 

I still bill insurance. I still review credentialing applications for my team.

 

I still use multiple EMRs. Why? Because I want to stay sharp and deliver advice that’s relevant and applicable to the real-world practices my clients are running.

 

So here’s my advice:

 

If you’re looking for a mentor, choose someone who has the kind of practice you want to build.

 

Study how they operate, not just what they post on Instagram.

 

Choose sustainability over hype.

 

Choose experience over ego.

 

And if you’re ready to work with a coach who’s still in the trenches, I’d love for you to check out my Reimbursement Coaching Program—built from 20 years of real-world, in-the-practice experience.

 

You can learn more about the voodoo-that-I-dodo HERE. 

 

 

Ever feel like getting credentialed as a dietitian is harder than joining an exclusive nightclub? 

 

You’ve got the paperwork, the patience, the drive… but you’re still not on the ‘it’ list. 

 

If you are feeling ‘all of these feels,’ then this blog post is for you.

 

 

Getting credentialed as a dietitian can be one of the most exciting steps in building your practice—hello, new client opportunities! 

 

But it can also feel painfully slow, confusing, and downright frustrating. 

 

 

Whether you’re brand new to insurance or trying to expand to more panels, here are the three big reasons credentialing feels so hard for dietitians—and how to make it easier.

 

Reason 1: The Process Wasn’t Built for Speed (or Sanity)

Insurance credentialing can take three to six months—and that’s if nothing gets lost along the way.

 

 

Applications bounce between departments, outdated systems, and (yes) the occasional e-fax machine.

 

 

To make matters worse, the process wasn’t designed specifically for dietitians.

 

 

You’re often lumped into “general provider” categories that don’t quite fit, which slows things down even more.

 

 

Amy P. Pro Tip: Start early. If you want to see insurance clients in January, begin your applications in July.

 

 

 

Reason 2: Every Insurance Company Plays by Different Rules

Credentialing would be easy if there were one standard application—but no.

 

 

Blue Cross might ask for one set of documents, Cigna another, and Medicare might ask for a different set of documents.

 

 

They have their own entire application universe.

 

It’s like walking into a grocery store where the milk is in the produce section and bread is in the freezer aisle—you spend most of your time figuring out where things go.

 

Amy P. Pro Tip: Create a master checklist for each payer’s requirements so you’re not starting from scratch every single time.

Reason 3: No One Teaches This in School

 

Raise your hand if your dietetics program taught you the Krebs cycle but not how to submit an NPI application. 

 

 

Yep, same, me too.

 

 

Credentialing requires learning a whole new language—EFTs, CAQH, taxonomy codes—and figuring it out on your own can take years.

 

 

Amy P. Pro Tip: Invest in learning the credentialing process once, and you’ll save yourself endless frustration and delays down the road.

 

The Good News

 

Yes, credentialing is confusing, time-consuming, and at times… soul-sucking. 

 

But once you understand the rules, it becomes much easier—and opens up a steady stream of new clients.

 

 

If you’d rather skip the frustration entirely, my team offers done-for-you credentialing services (we even set up your EFTs for you). 

 

Click here to apply.

 

 

Or, if you want someone to walk you through it so you can learn and grow your practice empire, my coaching program is the perfect fit. 

 

Click here to claim your crown.

 

 

No matter how you ‘do’ credentialing I am cheering for you. 

 

You are one less step away from financial freedom and having the practice of your dreams. 

 

Well, HELLOOO dietitians — Amy Plano, The Reimbursement Dietitian.

 

If your insurance claims are getting denied or your reimbursements are lower than expected, you’re likely skipping a few key steps in your insurance verification process.

 

And you’re not alone. Many dietitians hate verifying benefits, but if you half-ass this part (which MANY of you are doing), you are literally leaking money. 

 

Let’s fix that today. 

 

Here are the top three mistakes I see when it comes to insurance verification for dietitians — and exactly how to fix them.

 

❌ Mistake #1: Not Asking About Preventive Coverage

Most dietitians assume you need a diagnosis to bill insurance. But thanks to the Affordable Care Act, many plans actually cover nutrition counseling preventively, especially for conditions like:

 

• Obesity
• Prediabetes
• General wellness (YAY!)

These visits are often covered at 100% — no copay, no deductible. However, each insurance company has its own definition of preventative. Therefore, if you are not sure what those ICD 10 codes are, check out my CheatSheet HERE.

 

Questions to ask when verifying insurance benefits:

• “Is nutrition counseling covered preventively under this plan?”
• “Are there any diagnosis codes that allow for zero patient responsibility?”
• “Are benefits available under both preventive and medical coverage?”

 

 

❌ Mistake #2: Not Confirming Visit Limits

Just because a plan covers Medical Nutrition Therapy (MNT) doesn’t mean it covers it endlessly.

 

You need to confirm:

• How many visits are covered per year?
• Is it based on the calendar year or plan year? (Those are NOT the same.)
  
• Is prior authorization required after a certain number of sessions?

Missing this step can result in denied claims or you being forced to collect large out-of-pocket payments from surprised clients. Not a vibe anyone wants to sign up for.

❌ Mistake #3: Not Recording Reference Numbers

 

This might seem minor, but it’s HUGE.

 

You need to confirm:

• The name of the rep you spoke with
  
• The call reference number

If the insurance company gives you incorrect information — and they will (more than correct information)— this is your proof that you did your due diligence. 

 

Without it? You’re the one stuck footing the bill when a claim is denied.

Bottom Line:

 If you’re serious about succeeding with insurance in your nutrition practice, you MUST get your verification game tight.

 

✅ Ask about preventive AND medical coverage
✅ Confirm visit limits, frequency, and authorizations
✅ Always collect reference numbers from your calls

 

💥 Ready to Stop Leaking Money?

 

If you’re still Googling “how to verify benefits as a dietitian,” it’s time to stop winging it.

 

Inside my Reimbursement Coaching Program, I teach you exactly how to:

 

• Verify benefits with confidence
• Use proper codes for billing.
• Avoid the most common (and expensive) mistake.s
• Get paid what you deserve — consistently
• Step-by-step training
• A badass RD community
• 30-day money-back guarantee
  

👉 Click here to apply now.

Let’s get you credentialed, confident, and cashing those insurance checks.

 

 

Hugs & High Fives, Amy