Dietitian Reimbursement –
A New Billing Tool, & an important update on IBT Services!
By Susie Roberts, RDN, LD Reimbursement Co-Chair for IAND
As I mentioned in my November update, I participated in my first FNCE in October, where I attended several sessions on insurance reimbursement for dietitians. One recurrent theme seemed to run throughout the entire program: to increase your success, build relationships and network with others, whether it be fellow RDNs or colleagues at your organization (think physicians, nurses, the billing department, the CFO, etc.). I learned this first-hand at my initial clinical job at a critical access hospital in a rural community that needed
an RD to cover the regular dietitian’ maternity leave. I was given the opportunity to handle inpatient, outpatient, and the diabetes clinic service – yeah, very exciting! This included all aspects of coding, billing, and reimbursement, in addition to all the ‘regular’ dietitian duties – that was very scary!
I developed a tool, Commonly Used Outpatient Dietitian Procedures/Codes, to help me understand how to do billing. I organized the chart based on what type of health insurance the patient had, as well as the health condition(s). But after using the chart for a few weeks, I discovered no physician referrals were being made for Intensive Behavior Therapy (IBT), a benefit for Medicare beneficiaries with a BMI & 30 kg/m 2 . Digging deeper, I found that the IBT billing codes were not set up in the electronic medical record system. This
necessitated working with the chief financial officer, the billing department, and the IT specialist to update the system as well as procedures.
Next, I initiated a relationship building and education campaign with the primary care physicians as well as the nurses, to generate referrals. IBT is designed to provide the Medicare patient ongoing support for
weight loss in the primary care setting for up to a year. Dietitians can provide services as auxiliary personnel, and bill them as ‘incident to’, in accordance with CMS guidelines. It is crucial for RDNs to work collaboratively with primary care providers to render this service appropriately.
How does the IBT benefit work?
If you have any questions on reimbursement in general, please contact Susie Roberts at firstname.lastname@example.org, or Carrie Leiran at email@example.com.
Source: Intensive Behavioral for Obesity: Putting It Into Practice. www.eatright.org