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» ARTICLE CORRECTION
Correction to the article “What Is Weight Inclusive Care?” from the winter 2024 issue of Ventures. The FNCE® session “The Struggle Is Real: Providing Weight-Inclusive Care in a Weight-Centric World” was presented by Kasuen Mauldin, PhD, RD; Dawn Clifford, PhD, RDN; and Tara R. Lovinger, MS, RD.
Note From the Editor
AMY BROWNSTEIN MS, RDN NEWSLETTER EDITOR
Working in various fields of nutrition, our members achieve success and shine in all they do, particularly in the areas of leadership and mentoring� Connections built through the Nutrition Entrepreneur Dietetic Practice Group (NE DPG) have provided mentorship and pushed me to grow as a businesswoman I’ve learned from members who’ve achieved great success, from building private practices to establishing themselves as media dietitians� Mastermind sessions have pushed me to build out my business, set goals and be held accountable for each milestone
A good mentor brings experience and perspective They’ve been through the ups and downs and can offer insights that save you time, money and a lot of headaches Whether providing strategic advice, opening doors through their networks or just being a sounding board for your ideas, mentors can help accelerate your growth in ways you might never have imagined
Conversely, mastermind sessions are like a brain trust of other entrepreneurs in the same boat as you These groups are powerful because they offer collective wisdom When you bring your challenges to a mastermind group, you’re not
just getting one perspective; you’re getting the combined experience and creativity of multiple minds
Mentors and peers from mastermind groups can help you identify and overcome barriers, offer honest feedback and provide encouragement when you’re facing challenges� These relationships push you to grow as an entrepreneur and person, helping you develop confidence, resilience and a deeper understanding of your strengths and values
NE has been an invaluable resource for me over the past year Our members are inspiring and it has been rewarding to collaborate with and learn from them I look forward to learning more about my colleagues’ accomplishments and celebrating with them at each milestone�
Amy Brownstein, MS, RDN, is a privatepractice dietitian and consultant She is passionate about translating nutrition science into tangible, digestible information and recommendations Amy is an outdoor enthusiast, spending most of her time biking, hiking or running When she’s not outside, she enjoys baking and trying natural wines
Note From the Chair
LEAH TSUI MS, RDN, LDN CHAIR
I wouldn’t be in the position I am today without incredible mentorship and great leaders who showed me the way
It has been invaluable in my career to receive mentorship: from dietitians who introduced me to the field of nutrition as an undergrad, to dietetic interns who helped coach me for the interviews, to dietitian business coaches and colleagues who teach me each day how to be a better business owner, private practice dietitian, consultant and NE DPG Chair
I firmly believe that we are a combination of whom we hang out with, so I work to surround myself with folks who are generous with their time, gracious with their answers and have desires to better the world in their own spheres � By engaging with colleagues who are doing the work alongside me, and learning from those who share challenges and wins, I am inspired to keep on keeping on
NE hosts our Peer-to-Peer (P2P) Mastermind every other month, on the third Wednesday of the month at noon ET I highly encourage you to come join and actively participate in these gatherings � Our August P2P was wonderful, as we got to share space and time with folks from varying levels of nutrition entrepreneurship We exchanged ideas, wins and challenges within the smaller breakout-room group I loved that even though there were different niches and locations, each of us were dedicated to learning how to best serve our clients �
One of my favorite ways to be engaged in a leadership position is with the NE Executive Committee (yes, I know, I’m a little biased!) This has been my favorite way to be involved, working together with other like-valued dietitians who want to create meaningful content for our members This is my fourth year of volunteership, and I feel that I’ve grown immensely in my time on the Executive Committee� From talking with brands and organizations as the director of sponsorship to leading
meetings as the chair, my preparation and speaking skills have improved Of course we don’t all need to be chair of NE to be a leader, as there are many ways to lead within our own spheres of influence� I encourage you to find a place where you can be challenged to grow
Leah Tsui, MS, RDN, LDN, is the owner of Limitless Nutrition, where she does 1:1 virtual counseling, corporate workshops, and consults for several start-ups Leah combines her love of sports nutrition with an intuitive eating approach She’s also the partnerships + outreach coordinator for Weight Inclusive Nutrition and Dietetics (WIND) In her time off from being an RDN, you can find her coaching functional fitness at her favorite gym, reading a book (or two!) for the book clubs she's in, or running along the beach
Benefits of Volunteering
ELIZABETH REED MPH, RDN, LD DPG DELEGATE
Hanging in my office is a thankyou note from the Academy for 30+ years as a member For many years, I have volunteered for the Academy� Below are a few of the professional and personal benefits of being an Academy member volunteer
BENEFIT:
SHAPE OUR FUTURE
As the current Nutrition Entrepreneur (NE) delegate, I’m honored to represent NE while working with Registered Dietitian Nutritionists (RDNs) across nutrition specialties In small groups, we evaluate critical issues that change future RDN practice The voice of our constituents is heard by the Academy Board when we send our recommendations for future practice September marks the arrival of new critical issues I can’t wait to hear which will shape our future practice!
Shaping the future happens as a nutrition lobbyist in state and national governments As an RDN and former congressional intern, it felt vitally important to bring voice to hunger policy and the Farm Bill As a nutrition lobbyist I received support from the California Academy of Nutrition and Dietetics (CAND) and Academy in both written policy statements and connections Nutrition lobbyists can impact future nutrition practice in communities
BENEFIT:
LEARN NEW THINGS
As an analyst for the Academy’s Evidence Analysis library, I volunteered as a team member analyzing cardiovascular disease (CVD) research� Our work contributed to the educational materials RDNs use with patients every day This role was a wonderful way to combine professional work and home-life with children During naptime I was relearning statistics, reading and evaluating CVD research
Since I was a nutrition entrepreneur, one of my clients requested I volunteer one-on-one with homeless teenagers to provide nutrition education at our
food banks The teens were surviving on a few dollars a day, money given by passersby on the streets Many years past my graduate work in public health but with help from NE and the Academy, I created useful education for teens and appropriate nutrition materials for food banks I hadn’t considered this type of work before but was thankful for the opportunity to learn something new
BENEFIT: HAVE FUN, MEET NEW PEOPLE
Volunteering on a dietetic practice group (DPG) Executive Committee (EC) is a wonderful way to meet dietitians with your interests and focus DPG EC positions are both appointed and
elected NE volunteer positions utilize members’ strengths while providing excellent training, resources and support Shaping the future of the NE DPG while working alongside talented, fun RDNs is a wonderful way to spend your time� Come, try out a new role in the NE DPG I promise, it will be worth it!
Elizabeth Reed, MPH, RDN, LD, lives in beautiful Boulder, Colorado In her free time she can be found on a hiking trail or tasting the bounty of the local farmers’ market
How To Be a Successful Solopreneur Without Working Solo
JESSICA BEARDSLEY MS, RD, LDN INCOMING CHAIR
I first learned about mastermind groups a few years ago at a FNCE® session where the leaders modeled how a group might run for the first 10 minutes At the time I was in the process of starting my private practice and feeling quite alone in the journey I was intrigued I reached out to my friend and colleague - a dietitian I used to work with who had started her private practice the year before and floated the idea of a mastermind� Cut to the present; it has been four years since forming our mastermind and we’re still meeting and conversing weekly
WHAT IS A MASTERMIND?
A mastermind group is a collection of folks who meet regularly to offer brainstorming, accountability and problem solving to help each other achieve goals efficiently Members are often in the same field (like all dietitians), but it could be another commonality that brings the individuals together (e g , entrepreneurs from a local community or women business owners) Each member brings unique knowledge and experience that can be shared with the group A healthy mastermind group establishes expectations from the start and sticks to its guiding principles (frequency of meeting, shared time, topics, support and nondisclosure)
“I love being able to talk about struggles with peers who truly GET IT. I feel safe in our space,
like I won’t be judged.”
LW, MASTERMIND MEMBER
I am so thankful for my mastermind group There are four of us in the group, all located in the Eastern Time zone of the U S Each of us was connected by a previous job or group we were a part of� When we established our group, we were all in the first few years of private practice While we all came from different backgrounds, we were brought together as solopreneur dietitians and shared many of the same challenges With the support of my mastermind, I have been able to navigate launching private practice, marketing, credentialing with insurance, providing quality care while not burning out, and establishing best practices
Groups can meet as frequently as the members are willing to commit to Our group meets Tuesdays on Zoom for one hour Because our group is small, we can be more nimble with meetings when people are traveling The group was willing to shift to evening meetings for six months while I lived abroad in Australia where the time difference was challenging Our group works collaboratively because
we are committed to each other's success as dietitians, as women and as entrepreneurs A Stanford study showed that folks who collaborated in their work are more likely to focus on tasks longer, show less fatigue and have more successful outcomes While we are not “co-workers” exactly, we are getting the same benefit from the way our mastermind runs and the relationships we’ve built
TOP FOUR REASONS TO FORM A MASTERMIND GROUP AS A SOLOPRENEUR
1 Knowing you’re not alone. Being a solopreneur is hard and can be lonely Our group shares Marco Polos (recorded video messages) to the group when we need to vent
Sometimes it's a complaint about no-shows or rude clients Other times it's a celebration about a success in marketing or client victory I love that I can vent my frustrations when I’ve had three cancellations in one day It's comforting to know I’m not alone when I hear back from the group with a “Yup, I’ve been there It’s so annoying!”
answers. While taking insurance can be so great, it can also be a source of vexation
Each member of our group takes insurance and we’re always there to share what has worked for us in the past, so another member won’t have to learn it by trial-anderror I’ve benefited from members walking me through the process of submitting claims when I was brand-new to the system
3 Accountability. We all know how to set goals, but a key to following through with our action steps is to tell the group what we plan to do For example, each of our practices periodically raises rates - and while that’s a simple thing to do, we all struggle with it Are my rates too high? Will I lose clients? How do I tell them? Do I raise them for everyone across the board? Sometimes it takes working through these
challenges in a group setting to feel the confidence and conviction to do the uncomfortable work
Another challenge we all face is charging no-show fees It may seem silly, but it's something we need accountability to do!
4 Shared resources. As a dietitian in private practice, I’m constantly reading and listening to as much as I can about nutrition, body image and therapy modalities - but with limited time and attention Because I can’t sample everything, I rely on the group to get good recommendations for resources� For example, I heard a great podcast discussing body image and eating disorders (EDs) so I forwarded it to the group Also, some of my favorite books on EDs have come recommended by my mastermind In addition, we share handouts, worksheets and websites to help with client care
Investing your time and energy in a mastermind is incredibly beneficial to your growth and positive experience as a solopreneur� Not only are you navigating the business aspects together with a group, but you are also handling client and case management/treatment Sharing resources that you’ve found helpful is a great way to pay it forward Ultimately your time is efficiently used - either you’re getting tips from others who have tried things and figured out what does/does not work, or you’re spending the time learning the best way to do something and then telling your group about it Together you save time, effort and resources for your practices’ success
“I love feeling like I have ‘coworkers’ while in private practice. And it’s the good kind of coworkers who are actually your friends. It is a place of consistent support with people who understand in a way that no one else in our lives does.”
LS, MASTERMIND MEMBER
Jessica
Beardsley, MS, RD, LDN, is a weight-inclusive nutrition counselor with a private practice in Chapel Hill, North Carolina She loves to peruse cookbooks but rarely follows a recipe Jessica is passionate about helping clients live their best lives with intuitive eating When Jessica is not cooking food or talking about it, you’ll find her running, climbing rocks or dancing in the kitchen with her kids
Interview with Kelly Powers, Founder of Nourish
HEATHER RUDALAVAGE
RDN, LDN
CPE COORDINATOR
Recently, I was able to sit down with Kelly Powers, a fellow NE Executive Committee member and founder of Nourish, a meal-delivery company based in San Diego Here are her thoughts on becoming a business owner and what she would like to share with entrepreneurs who are just starting out
HEATHER: Tell me about your career path
KELLY: After completing my undergraduate degree, I needed to support myself and gain hours for my dietetic internship (DI) application so I worked at a private practice I enjoyed it so much; I ended up staying for two years Once I became an RD, I began working at a residential eating disorder (ED) clinic After three years there, I became a little burned out and felt like I needed a change So I moved to Rome, Italy, to get a graduate degree in food studies
I graduated and came back to the states with visions of entrepreneurship on my mind! I worked as a private chef
and kitchen manager for a family in San Francisco and began to build my virtual private practice (PP) on the side As I built up my PP, I learned that two obstacles for my clients were time constraints and skillsets in the kitchen� I knew it would make it easier for people to reach their health goals if I eliminated the work of meal planning, grocery shopping, prepping, cooking and cleaning up
HEATHER: What made you decide to do a meal delivery program?
KELLY: I make healthy foods that taste good and I love to feed people; it’s my favorite thing to do! Nourish allows me to combine my nutrition education with my culinary skills so I can reduce some barriers to eating healthy and help others achieve their goals
HEATHER: What are your biggest challenges as a business owner?
KELLY: Capital! Starting a business is expensive My raw costs are high because food is expensive I’m trying to keep food costs below 25% of what I am charging, but I purchase highquality organic products I also have to factor in packaging
HEATHER: Why do you love being a business owner?
KELLY: I like the creative freedom and I want to build something that’s bigger than me Owning a business allows me the flexibility to test things and pivot as needed Plus, I have family overseas, and entrepreneurship allows me to travel and visit them�
HEATHER: What do you know now that you wish you knew when you were just starting out as a dietitian?
KELLY: Go to market as soon as possible Get feedback, but not too much! Try to start, launch and release things before they are perfect, because things will evolve Accepting and honoring that will allow you to enjoy the process and have a higher rate of success�
HEATHER: What do you like to do on your days off?
KELLY: I don’t have any days off! All joking aside, I like to go to farmers’ markets but that is also something I need to do as part of my job of cooking meals for others I enjoy Pilates, cooking, walking, hiking and spending time with loved ones�
HEATHER: What are your must-have snacks?
KELLY: Dates and peanut butter
Heather Rudalavage is a weightinclusive RD As both a Certified Intuitive Eating Counselor and Certified Body Trust Coach in the Philadelphia area, she has been helping her clients achieve wellbeing in the practice she founded, Intuitive Nutrition, for over 15 years She is married to her high-school sweetheart and mom to three nearly grown kiddos When she isn't traveling, you can find her writing her first novel; stay tuned!
Peer Mentoring to Fast-Track Your Business
KAREN KENNEDY MS, CN, IFNCP INCOMING DIRECTOR OF ANNUAL CONFERENCE
If you want to build both your business and your clinical skills rapidly, nothing works better than peer mentoring�
The term “infobesity” is used to describe the state of our clients when they get overloaded with too much (useless?) information gathered from free sources like TikTok, webinars and YouTube They know a lot of stuff, but don’t know what actually applies to them or how to implement it
We know the value in hiring a nutrition professional to guide someone through that process We can fast-track our clients toward their health goals by tailoring the strategy to their specific needs
The same is true for your business
I had read books, downloaded countless freebies and attended free webinars But when I finally paid an expert for the person’s time, and they gave me the gold I was looking for, my clinical skills and business really took off
After I completed my board exam with the Integrative and Functional Nutrition Academy (IFNA), I was excited to start implementing all my new functional nutrition knowledge, but I quickly realized (again) that education isn’t everything I still needed practical help in implementing what I learned Especially in the gut health department I was seeing clients for metabolic health, but most of them had gastrointestinal (GI) issues that needed attention I understood the whole “5R” strategy in principle, but didn’t feel confident with functional labs or supplements� It made me nervous and I didn’t want to ask my patients to lay out that much cash without feeling more confident
The "5R" Protocol for Gut Restoration:
I quickly called Dianne Rishikoff, who is a mentor with IFNA specializing in functional gut health I started by sharing my current case with her and she easily guided me through it, with fantastic results� That success was such a boost to my confidence, as well as my client’s health, that the client wrote me a glowing testimonial and told her doctor about me and I still get referrals from her to this day
Dianne also answered my endless questions about insurance and billing, and how she structures her private practice The little things that nobody tells you about
Those three sessions with Diane catapulted me at least 12 months ahead
Not long afterwards, I found myself part of an online-practice group supporting people with hypermobility pain and Ehlers-Danlos Syndrome (EDS) Don’t even ask me how I ended up here, but I quickly realized I was in way, WAY over my head I was their only lead for the job and I needed the work, so I stepped up
After floundering briefly, I realized that I needed another mentor to accelerate my competence I called fellow Bastyr grad, Heidi Turner, who has been working with mast cell activation syndrome (MCAS) and other chronic illnesses for years We set up appointments every other week to help me navigate this new world� With her support, I got my feet under me� Again, I shared all my EDS cases with her and she helped me implement strategies and keep me from freaking out
Unlike self-study, a mentor can walk you through your actual patient case and help you get results while teaching you the mentor’s hard-won strategies In some cases, I earned zero dollars
Remove the stressors to the system like potentially problematic foods, chemicals, or microbes
Replace digestive secretions to improve function Examples include digestive enzymes and betaine-HCl
Repair the lining of the GI tract by providing nutrients which aid the body in healing
Reinoculate with beneficial probiotics and the prebiotic fibers they like to eat
Relax and address lifestyle stressors which are detrimental to the digestive process
Source: The Institute of Functional Medicine
from my client that week because my mentoring session cost the same But when you think of that as a free worldclass education delivering exactly what you need exactly when you need it, you can’t beat it� The return on that investment was big, both clinically and financially
I’ve got a deep bench of resources to pull on now and a community of kick-a** nutrition professionals to call on By mentoring each other, we elevate ourselves, our colleagues and our whole profession
Karen Kennedy, MS, CN, IFNCP, now enjoys mentoring other nutrition professionals because it’s fun to help these awesome nutrition professionals reach their potentials and enjoy their work more (and let’s be honest, there’s less charting!)
Karen is having fun being the “CGM QUEEN” over on YouTube under “Hack Your Blood Sugar ” Working with her best pal, Amy, as her marketing assistant, business is fun these days
Insurance-Based Dietitians: Superheroes in the Battle Against Chronic Disease
AMY PLANO MS, RD, CDE, CDN GUEST AUTHOR
CORE COMPETENCIES
2�3�4 Promotes health equity that enables everyone to have a fair opportunity to reach their desired health potentials where no one is disadvantaged from achieving the person’s goal
4 3 5 Advocates for financial support and insurance coverage for patients/ clients to ensure access to nutrition services
13 3 5 Takes into consideration World Health Organization and public health policies and standards to design programs, initiatives and interventions
OBJECTIVES:
By the end of reading this article, dietitians will be able to:
1 Identify the five steps dietitians need to complete in the insurance credentialing process
2 Describe the positive impact of dietitians participating in insurance on chronic disease
3 Summarize how medical nutrition therapy (MNT) provided by dietitians can improve clinical outcomes for chronic disease patients
With chronic diseases, such as diabetes, cardiovascular disease and obesity, representing a significant burden on the healthcare system and individuals' quality of life, insurance-based dietitians are perfectly positioned superheroes ready to swoop in and save the day Dietitians can be a pivotal force in chronic disease management and risk reduction Often, due to financial barriers, access to quality nutrition care remains challenging for many� By participating with insurance, dietitians can increase a community’s accessibility to nutrition experts This benefits the patient, is cost-effective
for the healthcare system and can be financially favorable for dietitians However, there is one major issue with this fairytale-like narrative Most dietitians don’t know how to accept insurance. This article will provide dietitians with the preliminary steps to start accepting insurance It will also explore how something as seemingly subtle as dietitians accepting insurance can have an enormous, far-reaching positive impact on chronic disease
Dietitians can be a pivotal force in chronic disease management and risk reduction.
According to the World Health Organization (WHO), chronic diseases account for 71% of all deaths globally, with cardiovascular diseases, cancer, respiratory diseases and diabetes being the primary contributors (1) Not surprisingly, chronic diseases represent a significant burden on the healthcare system, accounting for most healthcare expenditures and resource utilization
According to the Centers for Disease Control and Prevention (CDC), chronic diseases such as heart disease, cancer, diabetes and chronic lung disease are responsible for 90% of the $4 1 trillion spent annually on healthcare in the United States (2) These conditions require ongoing medical attention, frequent hospital visits and long-term medication management, contributing to high direct costs
Dietitians are essential in managing chronic diseases through their personalized approach to medical nutrition therapy (MNT), education and support Numerous studies have demonstrated the effectiveness of MNT in improving health outcomes for chronic disease patients A 2017 systematic review assessed the efficacy of dietetic consultations
in primary healthcare settings for managing various chronic diseases The analysis revealed that dietitian interventions led to significant improvements in clinical outcomes, such as blood pressure reduction in hypertensive patients, weight loss in individuals with obesity, and lipid profile improvements in those with cardiovascular disease The review concluded that dietitians play a vital role in the primary care management of chronic diseases, promoting better health outcomes through specialized dietary guidance (3)
While MNT has proven benefits, many patients face financial barriers to accessing these services This financial barrier can prevent patients from seeking or continuing necessary dietary guidance, undermining chronic disease management efforts With insurance, out-of-pocket consultations and ongoing support costs can be manageable, particularly for lowincome individuals or those already burdened by medical expenses
Despite all the evidence-based benefits of dietitians accepting insurance, very few do While their underlying reasons are likely multifactorial, one of the primary reasons for dietitians not pursuing insurance contracts is they don’t know how to get started In addition, many dietitians feel overwhelmed by the process� Given dietitians' lack of academic training regarding insurance, it is reasonable for them to feel this way Yet, many dietitians are unaware each insurance company actually follows a fairly standard credentialing process And while the process can take up to seven months, it is generally not nearly as challenging as dietitians anticipate�
The first step dietitians must take in the insurance credentialing process is determining where they will practice All insurance companies require a physical address During the public health emergency, several insurance companies waived this requirement However, practicing as a virtual-only insurance-based dietitian is no longer an option The requirement for an address doesn’t impact a dietitian’s ability to provide telehealth Instead, telehealth services are regulated at both a state and policy-specific level
Dietitians can choose from a variety of office options Some may opt to use their home addresses While this option is the least costly, not all insurance companies will credential dietitians in a residential setting and some dietitians may not be comfortable sharing a home address on the World Wide Web
To avoid those issues, some dietitians choose to sublease space from other health providers or a local gym Lastly, dietitians may rent from a co-working space like Regus or We-Work, where they can rent space by hour, day, week or month� This option can benefit dietitians starting in their insurancebased practices who don’t have a predictable volume of patients
The second step for dietitians to become insurance providers is to apply for an NPI (National Provider Identifier)
An NPI is a unique identification number assigned to U S -based health professionals The free application can be completed through the National Plan and Provider Enumeration System (NPPES) website (4)� It requires basic information such as the dietitian's name, contact information, Social Security number and practice location
An NPI is required to bill insurance
A provider’s NPI is used on every insurance claim to identify the dietitian who provided the service
The third step is to purchase malpractice insurance Malpractice insurance, or professional liability insurance, is insurance coverage designed to protect dietitians and other healthcare professionals from legal claims and lawsuits alleging negligence, errors or omissions in providing professional services
Like an NPI, malpractice insurance is required to participate with each insurance company While there are different options for malpractice, members of the Academy of Nutrition and Dietetics receive reduced rates through the Association Member Benefits Advisors (AMBA) While the type of coverage needed will vary based on the specific services the dietitian elects to provide, general malpractice insurance for individual dietitians typically costs less than $200 per year (5)
While there are different options for malpractice insurance, members of the Academy of Nutrition and Dietetics receive reduced rates through the Association Member Benefits Advisors (AMBA).
Once the dietitian has an office location, NPI number and malpractice insurance, the next step in the insurance credentialing process is to complete the information requested in the Council for Affordable Quality Healthcare (CAQH) Provider Data Portal (6) This online database allows healthcare providers to store and update their professional and practice information in a single location� Dietitians enter their information once into the CAQH Provider Data Portal, which can be accessed by multiple health plans and other organizations for credentialing purposes This eliminates the need for dietitians to submit the same information multiple times to different health plans The dietitian creates a comprehensive profile with personal, professional and practice information� In addition, dietitians can expect
to upload supporting documents, such as licenses, certifications and malpractice insurance Certain insurance companies may request additional information or documents, which providers can upload directly to their profiles
The final step for dietitians in the insurance credentialing process is determining which insurance companies to participate in within their state Dietitians must be credentialed in the state where their physical office is located Most enrollment is done online through each respective insurance company’s provider webpage The credentialing process can last three to six months, depending on a dietitian’s state Each state differs relative to which insurance companies have the highest enrollment However, all states have the following national insurance companies: Aetna, Blue Cross Blue Shield, Cigna and UnitedHealthCare� In addition, dietitians can enroll in Medicare, and certain states also offer Medicaid coverage for MNT
By applying to work with all insurance companies within their state, dietitians maximize their impact by supporting all patients with chronic diseases Reimbursement rates vary by state and insurance company The rates are private knowledge and are only made known to the dietitian when the dietitian signs the contract, which can be highly frustrating� However, because Medicare is a federal program, reimbursement rates for MNT are public Dietitians can look at Medicare-published rates to
get an overall understanding of what insurance will reimburse On average, the reimbursement rate from Medicare for an initial MNT appointment ranges from approximately $27 80 to $39 12 per 15-minute unit, which translates to about $111 20 to $156 48 per hour These rates can vary significantly by state, with Alaska having the highest rates and Arkansas and Missouri among the lowest (7)
As mentioned above, the reimbursement rates vary from state to state and there are a few other downsides to note when accepting insurance Let’s explore them here:
1
BENEFITS VARY:
A patient’s benefits are determined on a policy level, NOT a plan level This means that while some plans cover 100% of nutrition visits, other plans may place a limit on the number of visits, the diagnoses that are covered or what percentage of the visit is covered This can be confusing for you and your patients, and limits on covered visits can be a barrier to completing a care plan While your first few claims may have some ups and downs, you will soon start to see trends and become more confident with each claim you submit As with anything in life, the more claims you submit, the easier the process will be
2 NOT ALL NETWORKS ARE OPEN:
Insurance companies credential you based on the zip code you provide for your physical office address Depending upon how many other dietitians are already “participating” as in-network providers with the insurance company in that zip code, the insurance company may inform you that the network is closed to new providers “Participating” is in quotation marks because often when you review the directory you will not see ANY Registered Dietitians within a 25-mile radius of your office zip code Or, there are none who work with the types of patients you do In fact, more often than not, many of the dietitians listed in the directory no longer practice at the address they are listed at (or practice at all!), yet they are still taking up a “spot” in a limited provider base
3
POOR
COMMUNICATION:
If you have ever had to call your own insurance company, this will not come as a surprise Insurance companies can be terrible communicators! To be honest, I don’t know how companies get away with it With long wait times, getting the runaround, ill-informed service representatives and automated email replies, the lack of communication can be maddening This is where hiring a medical biller can save you hours of frustration�
4 YOU MOST LIKELY DID NOT LEARN THIS IN SCHOOL: I know I didn’t Since we did not learn how to accept insurance and submit claims for reimbursement in school, it might feel overwhelming and it can be hard to know where to even start I promise, there are mentors, courses, social media groups and even DPGs (hello, Nutrition Entrepreneurs!) that offer the most up-to-date information on how to take your private practice to the next level by accepting insurance� There are already thousands of insurance-based dietitians They figured it out and you can too!
5 BETTER COVERAGE
There are mentors, courses, social media groups and even DPGs that offer the most upto-date information on how to take your private practice to the next level by accepting insurance.
FOR CERTAIN CONDITIONS: Conditions such as weight management and diagnoses that go hand-in-hand with weight management like pre-diabetes, diabetes, PCOS, hypertension and high cholesterol are generally covered This makes billing insurance easy because the majority of insurance plans have to cover preventative services due to the policies enforced by the Affordable Care Act (ACA) The conditions noted above are part of the criteria for services covered under the ACA� When patients are seen and properly billed for preventative services, they pay nothing for these services This, fortunately, does not mean that other diet-related conditions are not covered We live in a time and place where the majority of diseases and disorders we as dietitians treat from a dietary standpoint are in fact covered� However, many of these conditions are covered on the medical side of a patient’s insurance policy In many states, there are even laws in place where certain conditions MUST be covered Two of the most common ones are eating disorders and diabetes� While these conditions may not fall under the patient’s preventative side of the policy, the patient has covered services and you will be reimbursed your normal rate minus any applicable cost shares your patient has
With insurance having few downsides and many positives, dietitians who accept insurance can serve as vital providers in the fight against chronic disease They just need the right resources and direction to get started� Going from a private-pay to an insurance-based practice is a subtle administrative shift that can have farreaching and positive impacts on both the healthcare system, the impacted patients and the lives of the dietitians
By your accepting insurance, everyone wins
« Scan the QR code to access the complete list of references for this article
Amy Plano, The Reimbursement Dietitian, RD, MS, CDE, CDN, is a successful private practice dietitian
passionate about helping dietitians create a profitable nutrition private practice using an insured-based model Together with her husband, Marc Plano, she runs the profitable, The Plano Program, a health and wellness-based center in Orange, CT Through her coaching programs, online resources, and seminars, she teaches dietitians exactly how to use health insurance to make money in their nutrition practices
Peer Mentoring: Creating Your Own Group
KIMBERLY MARSH MS, RD, LD
INCOMING NEWSLETTER EDITOR
As I have gotten to know many other dietitian entrepreneurs, I have discovered we all have a lot in common We want to do everything the “right” way� We are keenly aware of all we do not know and want to learn as much as we can We want guidance from someone who has had success
All of these are valid thoughts and concerns And there are a lot of coaches out there who can help dietitians as they start their businesses But I know I have signed up for too many coaching programs without realizing all I really need is accountability as well as someone to give feedback on ideas�
If you find yourself in a similar situation, you can create that for yourself for free� Here are some ways to do that�
1 Participate in the NE Mastermind You can get feedback on the calls as well as find people to create an outside group with�
2 Post online that you are looking for an accountability partner� The NE Hub forum is a great place to do that Or there are many dietitian entrepreneur Facebook groups out there
3 Look locally! I’m in a local networking group and can talk to entrepreneurs from lots of different industries It is so helpful to get feedback with outside perspectives
4 If you are in a paid coaching program, get to know other RDs in the program Create your own little accountability group with them I’m still connected with many RDs this way long after the program has ended
I have been part of a variety of groups of dietitians who have helped each other in this way Here are some tips for setting it up�
1 Set a check-in schedule� Have regular check-ins that are brief (text, Voxer, WhatsApp, etc ) It can be daily, every other day or weekly These can be detailed or simple A simple example is texting your goals for the day in the morning In the evening, just text yes or no with the number of the goal�
2 Set a call schedule Have a call together at least monthly to really check in and get feedback�
3 Be hard on each other and yourself If everyone in the group validates excuses for not getting things done, no one will make progress� You need peers who will push you And you need to be that peer for others
Obviously there are many benefits to paid coaching Most of us provide that service for our clients But we all know that even our clients need a support network around them Don’t forget to build one for yourself!
Kimberly Marsh, MS, RD, blogger at lowiodine dietitian com, loves to be outdoors, just not camping While not very good at any of these, she enjoys hiking, mountain biking, skiing, paddleboarding, and in general appreciating our beautiful world Luckily, her home in Colorado affords ample opportunities for these activities
Price: $18 95 for the paperback; $9 95 for the ebook
Addressing childhood obesity is a challenge for parents because certain actions can lead to children’s developing an unhealthy relationship with food and poor body image What is the best approach to help a child reach a healthy weight without triggering an obsession with weight?
The goal of Food, Fun, N’ Fitness is to provide parents with a realistic approach to ensure proper nutrition and healthy physical activity throughout childhood and adolescence Mary C Friesz knows the challenges of childhood obesity firsthand as she shares her personal story of suffering with obesity as a child and then later battling an eating disorder
This is a helpful book to share with parents who don’t know where to start with nutrition for their child� A majority of the book discusses the contributing factors of childhood obesity and eating disorders, and provides a nutrition lesson on nutrient needs throughout childhood The explanations are easy to understand and geared toward someone without a nutrition background
The final part of the book provides tools for parents to design a healthy lifestyle for their children as well as for themselves Practical tips are given for grocery shopping, healthy cooking methods, and how to make fitness fun
A nutrition entrepreneur can recommend this book to clients as a resource to cover the nutrition basics for healthy eating as a family and get them started on making lifestyle changes
Reviewer: Sarah Alsing, MS, RD
Title: Media Dietitian, Blogger, and Private Practice Owner
Sarah Alsing, MS, RD, helps everyday athletes fuel for optimal performance She shares recipes on her blog, delightfullyfueled com, to make meal prep delicious, nutritious and easy You’ll find her doing CrossFit and training for her first marathon Sarah is also a proud dog mom and loves true crime
FNCE® Spotlights
More Info: NEdpg.org/FNCE
2024 NE Networking Event
Sunday, October 6, 6:00 p.m. to 8:30 p.m.
Location: Hyatt Regency
NE is hosting a Networking Event Sunday, October 6, in Minneapolis for FNCE® 2024! Join us for networking, food and fun, which includes an open bar and a mouth-watering menu
Pricing: Sponsored by:
NE Members – $49
NE Student – $35
Retired Member – $35
Non-member – $69
FALL 2024 | VOLUME LIII | NUMBER 2
6301 Snidercrest Rd
Mason, OH 45040
Upcoming Events and Webinars:
22
Effectively Connecting for Better Health Outcomes: Communication That Influences Change
Speaker: Sonja Stetzler, MA, RDN, CPC
Date: Tuesday, October 22, 3 p m EST
16
NE Peer 2 Peer Mastermind Session
Come network and get accountability in your ventures!
Date: Wednesday, October 16, at noon ET
29
Deep Dive into Motivational Interviewing for Dietitians
Speaker: Joyce Faraj-Ardura, PhD, RD
Date: Tuesday, October 29, 2:30 p m EST
21
Food as Medicine: Opportunities for Nutrition Entrepreneurs
Speaker: Dina Aronson, MS, RDN
Date: Thursday November 21st, 3 p m ET
NEW NUTRITION ENTREPRENEURS DPG WEBSITE COMING SOON!
We’re thrilled to announce that we’re transitioning our website to a new platform, designed to better serve you The new site will be a hub for connecting with fellow members, accessing essential tools and resources, and staying up-to-date on everything related to nutrition entrepreneurship and business With an improved design and streamlined content, it will be easier than ever to find the key resources you need Stay tuned for more updates—we can’t wait for you to explore what’s coming!
