Your appointments with Leslie will be educational, enjoyable and confidential. Appointments may be scheduled or cancelled via phone by calling (317) 443-5059 or via email by emailing firstname.lastname@example.org. Patients who do not reschedule or cancel appointments with 24 hours advanced notice or do not show up for their scheduled appointment will be charged a $25.00 fee. The office will make reasonable attempts to confirm appointments one day in advance of the appointment date.
It remains the patient’s responsibility to keep or reschedule appointments in compliance with the above policy. Exceptions will be made for medical or family emergencies.
Payment options include the following: Insurance, Cash, Check, or Credit card. With the exception of insurance, payment is due at the time of service. Outstanding balances will result in interruption in nutrition counseling until all bills are paid.
Returned checks are subject to a $25 fee.
Some insurance plans cover nutrition counseling while others will only reimburse for certain diagnoses or not at all. At the current time Leslie is a provider for Blue Cross and Blue Shield Insurance, United Healthcare, Humana, and Medicare. In order to make the insurance process as easy as possible, a call to verify nutrition counseling benefits is made on behalf of every client prior to scheduling an appointment.
For those whose insurance plans cover out-of-network medical nutrition therapy services, our office can provide you with a CMS 1500 form with the appropriate medical nutrition therapy procedure codes that you can turn in to your insurance company for reimbursement. All costs not covered by insurance will be the responsibility of the patient
MD referrals are welcome but not required unless your insurance plan requires a doctor referral for nutrition counseling/medical nutrition therapy. In instances where a referral is required, please contact your doctor’s office directly. Physician offices may fax referrals to Leslie’s private and secure fax at (317) 747-7471. All medical information will remain confidential.
Informed Consent for Medical Nutrition Therapy
At the time of service, patients not referred by a physician will be asked to sign this form if they are paying for services using insurance or if they want their nutrition counseling information released to other health care providers or family members. Those who have been referred by a physician do not need to fill out this form since they have already agreed to have the doctor and dietitian coordinate their care. In all cases, patients private information will not be released to anyone, except their doctor, unless informed consent has been given.
Each client is unique and the number of visits dependent upon the services agreed upon. In some instances, such as when a client desires a pre-race nutrition plan for sports nutrition services, only one visit is required; while in other cases, such as weight loss or diabetes management, a minimum of three sessions are recommended with monthly visits thereafter. Reasons for follow-up visits include additional assistance needed to make progress towards nutrition goals, additional nutrition education, and assistance with behavior modification…to name a few. During each counseling session the need for additional sessions will be determined based on collaboration with the client and a thorough evaluation of progress towards goals.