I am available during the following hours and sometimes for same day appointments.
--Tuesday through Friday 10 am to 5:30pm --Saturdays: 11:00am to 5:00pm.
What to Expect
If you bring all the paperwork completely filled out, we can spend more time working on your goals. visit the forms page to download paperwork for new consults and insurance in advance.
The first appointment is a complete nutrition assessment and takes the entire 60 minutes. Beginning nutrition knowledge and anthropometric data is assessed, health history and risk factors are determined. Nutrition related labs (if available) are reviewed. Please bring any current labs (less that 3 mos old.) The most common useful labs: CBC, CMP with albumin and FASTING glucose, A1c, vitamin D, lipids panel, liver panel (if warranted), bone density (if warrented), anemia panel, and B12. Not all of these are needed. It depends on why you need to see a dietitian.
The second appointment is usually scheduled 1 to 7 days after the first appointment and is an hour long. It can be broken into two smaller 1/2 hour sessions if needed. During the follow up appointments we will review your questions, any homework given. We will review your nutrition consult report with your estimated needs. We will begin any medical nutrition therapy education first. If time remains, we will cover any nutrition risk issues uncovered at the assessment, and cover basic nutrition educational materials. Topics not covered in the second appointment are covered in the third and subsequent appointments.
The third appointment (30 minutes to 60 minutes) we review questions, homework, and continue the Medical Nutrition Therapy education process for why you have come. Each visit from this point I will usually weigh you and do a waist and hip circumference.
Pre and post knowledge will be assessed to objectively evaluate, measure, and document dietetic intervention efficacy.
Follow up appointments will be scheduled based on need and time needed to see improvement. Average number of visits range from 4 to 12 or more visits.
Visit four on--consults are 15 minutes to 60 minutes depending on why you have come.
You may be scheduled into a group class in between consults to maximize education opportunity.
CONSULT FESS / COPAYMENTS ARE DUE AT THE TIME OF SERVICE.
Your consult fee covers pre-appointment prep-work, insurance preauthorization / verification, the actual consult time, medication review, basic research as needed, the clinical evaluation of the assessment and writing of the consult reports, educational material assembly, insurance billing / payment follow up / noncoverage problem solving, and other post-appointment requirements. It is not uncommon for me to put in 3+ hours for the one hour I charge for.
We accept: Visa, M/C, Discover, American Express, ATM / Debit, Checks, money orders, cash, BCBS, Cigna, Medicare-B, Medicaid, Cook Childrens, AmeriGroup, Superior, Bravo, United Health, Health Net, Pacificare, Great-West, Health Allies, Access One, Medical Resource, Premara Blue Cross, and Aetna are currently accepted.
Please note: your insurance may not cover "nutritional consults". Please check ahead of time to see if you are covered to see a dietitian for more than "diabetes management".To get correct information, make sure to talk to a human representative. I usually fall under the "specialist" copay.
If you have POS or HMO insurance or if you are unsure, please make sure your doctor's office generates a referral authorization to see me. A letter will be sent to you and me and is required prior to your visit in order to be covered. In some cases, a referral letter won't cover you if the diagnosis is excluded on your policy. (Example, if you are only covered for diabetes, referral letter or not, it won't be covered.). Check for policy exclusions and "day/dollar" limits. Make sure your insurance doesn't require your deductible to be met first.
For Medicare part B--You must have a written referral with a diagnosis code(s) and your doctor's NPI number at the first visit. Medicare only covers for diabetes type 1, type 2, gestational diabetes, and kidney disease. You can still see a dietitian if you want, but Medicare probably won't cover it. Medicare part B allows you to see a dietitian for 3 hours in the first year and 2 hours each year after only if your doctor refers you to a dietitian each time. Additional hours above that can be appealed if the dietitian deems it medically necessary on a case by case basis with doctor recommendation.
Emphasis is placed on the positive. I show clients how to eat, not how to diet and what you can eat rather than what you can't. This lifestyle / behavior modification education process takes time. The average person comes 4 to 12 or more times depending on why they have come.
I am not one to hand you a diet, pat you on the head and wish you good luck. I am invested in your long term success. I take my job very personally and get great joy when you succeed.
Long-term behavior change is the focus. Patience with yourself is key. This didn't happen overnight and it won't get better overnight. There is no magic pill for medical nutrition therapy. Your willingness to learn, dedication, determination, patience with yourself and the process, and discipline will be the key factors in your success. You will have times where you don't do it right. Be patient, you are in the learning process.
The ideal therapeutic method is presented first. If that doesn't work for you, alternative Evidenced- Based methods will be discussed and developed to meet your individualized needs. I am very creative.
Emphasis is put on learning, long term concept retention, and positive behavior modification. All medical nutrition therapy concepts and nutrition education classes utilize evidenced based guidelines.
I do not support, teach, or assist patients with fad diets. Only evidenced based therapies are used.
Bring at least a 3-day food diary (written or picture) for the dietitian to evaluate. A food diary includes every thing that enters your mouth (fluid, food, supplement, etc) in the last 72 hours for a typical day. Please note, this does not include unusual days, holidays, etc.
Bring a picture of your cupboard/pantry and what is in your refrigerator (I promise I won't judge you!! :) I am here to help.) A camera phone works great if you have one.
Recent Lab work (with in last 3 months) You may need to fill out a medical release from your MD
Bring a referral from your doctor or preauthorization letter if your insurance requires it.
Bring your insurance card(s) and ID
Current blood pressure from MD or local pharmacy machine
Check with your insurance company to see if "Nutritional Counseling", "Dietitian Services", or "Diabetes Management" are covered. If this service is covered, please bring the coverage details prior to your appointment and your coverage confirmation number.
Determine if you have a deductible and if that deductible has been met. If it hasn't you will be responsible for the cost of services rendered. A claim will be submitted so any cost you incur will go towards your deductible.
Ask what percentage is covered for In Network and Out of Network providers.
Receipts are provided for payments/copayments received
Please come hydrated and don't wear heavy clothes if you want an accurate weighing.
Wear shoes and socks that can be removed.
Please bring a list of prescriptions, supplements, and herbs taken. Please note the name, quantity and frequency. "PRN" means taken as needed.