Insurance Billing

The Complete Insurance Verification Call Script for Dietitians (Free)

The exact 21-question script to verify nutrition benefits before a first session — covering preventive vs. medical benefits, visit limits, telehealth, referrals, and cost-share — plus a log template. No email gate.

By Alva Health Team · Published July 12, 2026 · ← All articles

Verifying benefits before the first session is the single highest-leverage habit in insurance-based practice — it prevents the entire biggest category of claim denials. It's also tedious: a payer phone tree, 20 minutes of hold music, and an inconsistent rep on the other end.

This is the complete script we'd use — every question, in order, with why each one matters and a log template to record answers. It's free, no email required. Use it as-is, or skip to the end for the version where nobody makes the call at all.

Before you dial

Have in front of you:

Patient's member ID, date of birth, and full name exactly as on the card
Your NPI and Tax ID
The payer's provider services number (on the back of the card)
The CPT codes you bill: 97802, 97803 (and 97804 if you run groups)
The ICD-10 codes you're considering: Z71.3, plus the referral diagnosis

Call the provider line, not member services — you'll get benefit detail member reps can't see. Expect 15–45 minutes.

The script: 21 questions in 6 blocks

Block 1 — Coverage basics

"I'm calling to verify outpatient nutrition counseling benefits — Medical Nutrition Therapy — for a member. Does this plan cover CPT codes 97802 and 97803?"
"Is coverage the same for in-network providers in an office setting and via telehealth?"
"Am I showing as in-network for this member's specific plan?" — network status is plan-specific, not payer-wide. This one question catches the nasty surprise of being in-network with the payer but not the patient's product.

Block 2 — Preventive vs. medical routing (the money question)

"Is nutrition counseling covered under the preventive benefit — for example billed with Z71.3 — and if so, at what cost-share?" Preventive routing often means $0 patient responsibility and generous or unlimited visits.
"Which diagnosis codes qualify for the preventive benefit?"
"If billed under the medical benefit with a medical diagnosis, what's the cost-share?"
"Does the plan require a specific diagnosis order — for example, does Z71.3 need to be primary, or is it excluded as primary?" Payers differ sharply here; this is the trap we covered in the CPT codes guide.

Block 3 — Limits

"How many nutrition visits are allowed per plan year?"
"How many have been used so far this year?" — not just the allowance; the remaining balance is what you can actually plan care around.
"Is there a limit on units per visit?" (Some plans cap at 4 units.)
"When does the plan year renew?"

Block 4 — Requirements

"Is a physician referral required for MNT? If yes, does it need to be on file before the first visit?"
"Is prior authorization required for any nutrition services?"
"Are there covered-condition restrictions — for example, diabetes or CKD only?"

Block 5 — Telehealth specifics

"For telehealth, which place-of-service code do you require — POS 10 or POS 02 — and which modifier — 95 or GT?"
"Is telehealth reimbursed at the same rate as in-person?"
"Any restrictions on the patient's location during the visit?"

Block 6 — Money and paper trail

"What is the member's copay or coinsurance for these services, and does the deductible apply? How much of it has been met?"
"What's the timely filing window for claims?"
"Can you confirm the claims submission address / payer ID?"
"May I have your name and a call reference number?" — say this one verbatim, every time. A quote of benefits isn't a guarantee of payment, but a dated reference number is your best weapon in an appeal.

The verification log (copy this)

INSURANCE VERIFICATION LOG
Patient: ______________  DOB: ______  Member ID: ______________
Payer: ________  Plan/product: ________  Call date: ______

Rep name: ________  Reference #: ________
In-network for this plan:  Y / N
Preventive benefit:  Y / N   Cost-share: ____  Dx codes accepted: ______
Medical benefit cost-share:  copay $____ / coins ____%  Deductible: $____ met of $____
Visits allowed/used/remaining:  ____ / ____ / ____   Unit cap: ____
Referral required:  Y / N (on file: Y/N)   Prior auth:  Y / N
Telehealth: covered Y/N  POS: ____  Modifier: ____  Parity: Y/N
Plan year renews: ______   Timely filing: ____ days
Notes: ________________________________________________

Store it with the client record and re-verify at plan renewal — January re-verification alone prevents a wave of denials.

Why this script is free (and the cheat sheets aren't)

You may have seen versions of this behind email gates or inside paid coaching programs. We publish it open because the script was never the hard part — the hard part is doing this 8–15 times a month, plus re-verifications, forever. At 20–40 minutes per call, verification alone is 3–8 hours of monthly unpaid admin.

That's the part we think should disappear entirely.

How Alva helps: Alva verifies nutrition benefits automatically when a client books — preventive vs. medical routing, visits remaining, referral requirements, telehealth rules, cost-share — and re-checks coverage every 30 days so renewals never blindside you. The answers land in the client record; the hold music is nobody's problem. Start a 7-day free trial — after that it's $99/month, which is less than two hours of your time on hold.

Frequently asked questions

What should a dietitian ask when verifying insurance benefits?

The essentials: whether nutrition counseling/MNT is covered, under which benefit (preventive vs. medical), for which diagnoses, how many visits per year (and how many remain), whether a physician referral or prior authorization is required, whether telehealth is covered and with which POS/modifier, and the patient's copay, coinsurance, and deductible status. Always record the date, the representative's name, and the reference number.

Why does it matter if nutrition is covered under the preventive or medical benefit?

Preventive benefits (driven by ACA rules) often cover nutrition counseling at 100% with no patient cost-share, typically billed with Z71.3 and sometimes unlimited visits. Medical benefits usually apply copays and deductibles and require a covered medical diagnosis. The routing changes your coding, the patient's bill, and how many sessions you can plan.

Does a verification phone call guarantee the claim will be paid?

No — payers state that a quote of benefits is not a guarantee of payment. But a documented call (date, rep name, reference number) materially strengthens appeals when a payer denies something they verbally confirmed, and it prevents the most common denial category: services that were never covered.

How long does insurance verification take per patient?

A thorough phone verification typically takes 15–45 minutes including hold time. Electronic eligibility checks return basic coverage in seconds, but often lack nutrition-specific detail (visit limits used, preventive routing), which is why many practices still call — or use software that automates the full check.

How often should I re-verify a patient's insurance?

At minimum every plan year (January renewals change everything), and ideally monthly for active clients — coverage changes mid-year with job changes more often than you'd expect. Automated re-verification removes this from your calendar entirely.