Accepting insurance in your nutrition practice can be an extremely effective way to increase client load and grow your business. In comparison to a self-pay financial model, insurance-based practices tend to have a steady referral of new clients, as well as more consistent revenue. However, the caveat with insurance billing for nutrition professionals is that insurance payers will only reimburse for time spent counseling your client. This means any of the work that you do outside of session, whether it’s answering client emails, reviewing food journals, or connecting with your client’s healthcare team, will go unpaid. Depending on your client load, this can reflect a significant amount of time, and revenue, lost for your business.

But what if there was a way to establish other channels of revenue within your insurance-based practice? Although insurance may not reimburse for these services, there is the opportunity to offer value-added services to your clients at a self-pay rate. Now to be transparent, the objective is not to obligate insurance-based clients to pay out-of-pocket for nutrition services – in fact, we want clients to make the most of their insurance coverage. Even still, there are a variety of nutrition services and related tests that typically are not covered by any insurance payer — and would be valuable for your clients. In this case, adding to your services, and being transparent that they are an out-of-pocket expense, can allow your client to decide if they would like to make the investment.

In the end, your client receives more support, care, or information, that may otherwise not be available to them. Your wellness business also is able to diversify its services and continue to grow in revenue.

Here are 4 nutrition-related services to offer as self-pay add-ons to your nutrition practice:

1. Create a monthly subscription for nutrition support between sessions

Circling back to what classifies as “billable” services for insurance — nutrition professionals cannot bill insurance for time spent answering client messages, emails, questions, reviewing food journals, or doing any research on behalf of your client’s case. This can easily add-up to many hours of work every week going unpaid. Some nutrition providers choose to not offer this between session support, as this is valuable time that can be spent in-session or working towards other business responsibilities. Other providers do spend time on these support services, knowing that it leads to better client retention and improved outcomes.

As an approach to receiving compensation for this non-billable support time, nutrition providers can offer a “nutrition support subscription” service to insurance-based clients. Clients who are interested in receiving more between session care, like ongoing food journal reviews and messenger support, can pay out-of-pocket for this ongoing service. Many nutrition providers call this concierge service a “Support Package,” “Accountability Package,” or “Accountability Booster.”

To create the add-on service that will bring the most value to your nutrition clients, think through any between-session work that you often provide, and what support your clients will most benefit from. Calculate how much time per client you would expect to spend on these services, and then multiple this time by your desired hourly rate to guide you in your pricing.

Example:

$40/month “Accountability Package”

• Food journal review 1-2 times/week
• Unlimited between-session messenger support

After you have a good idea of what your subscription would include, and your pricing, you can survey 5-10 of your existing clients to gauge interest. Research if the support is something they would be willing to pay out-of-pocket for, and sign-up those who are interested. There is a rule of thumb in business — people can think highly of your service, but the true tell is if they are willing to pay for it. Starting out with a few clients will help you gauge if you’ve calculated the time-investment correctly, and to work out an kinks in your process or technology.

Make any adjustments to your services based on their feedback — and then launch your new subscription service to your whole client-base. By blending an insurance-based billing policy with self-pay services, nutrition providers are able to consistently provide the between-session support at an affordable rate for clients.

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2. Offer a meal-planning subscription service

Just as with messaging or emailing clients, or reviewing food journals — insurance does not reimburse for the additional time needed to create a meal plan for clients. Quite typically in nutritional care, clients will ask for a weekly meal plan that they can follow. If this is a service that you often provide, you’ll likely find yourself spending time after your client’s session creating a meal plan that takes into consideration their food preferences and nutritional needs. Meal plan creation, while practical for clients, can be a major source of unpaid time spent by professionals.

For the clients who want the added support, consider creating a “Meal Planning Subscription” service. As with an “Accountability Subscription,” think through what you would like to include in this service, how much time you would like to commit on behalf of each client, and calculate your pricing. This is another service that could be beneficial to “test-run” with a handful of existing clients, to evaluate its demand and success among your clientele.

Example:

$60/month “Meal Planning Subscription”

• Weekly meal plan including 7 healthy dinner options  
• New recipes each week
• Weekly grocery list provided

One thing to consider is which meals you’ll include in your meal planning (ie 3 meals/day and snacks, or just dinner meals?). Keeping in mind, the more time you’ll spend curating these meal plans, the more costly your subscription service should be. There are also several meal planning apps available to dietitians and nutrition professionals that can help to streamline the meal planning process.

3. Create a virtual group support class

Insurance reimbursement for telehealth nutrition counseling, while improving, can be inconsistent depending on your client’s benefits. In-person group nutrition services may be billable under CPT code 97804, however the overhead costs of finding and renting in-person spaces can be a challenge for nutrition practices. In addition, many clients may be interested in the additional support, but finding the time to commute into another in-person session just doesn’t work with their schedules.

Virtual support groups can be an incredibly powerful way to provide more care, at an affordable rate for a larger group of clients. For many clients, having the support and feedback from their peers can help them feel motivated to work towards their wellness goals. Also, virtual support groups offer flexibility for providers and clients as well as saves on overhead costs, making groups more affordable for attendees.

With a larger number of attendees, and no over-head, nutrition providers can run support groups with regularity, and generate additional income for their nutrition practice.

Example:

$30/Group Class “Virtual Weight Loss Support Class”

• Attend a weekly 30 minute group class
• A new topic will be discussed each week, navigating major barriers to achieving a healthy weight (and sustaining weight loss)
• Gain access to a network of peers in our exclusive private group messenger

4. Offer premium nutrition tests and assessments

One of the biggest trends in wellness is providing personalized nutritional care. More and more clients are seeking to make dietary changes that are customized specifically for their bodies. With developing technologies, nutrition professionals are able to offer additional nutritional lab testing that can help reveal important information about a client’s nutritional needs, including :

• DNA testing
• Food sensitivity testing
• Comprehensive vitamin and nutrient testing
• Detailed body composition analyses
• Metabolism testing

Some of these test kits can be purchased directly by nutritionists from companies and easily administered in-office to clients. Other services, like body composition and metabolism testing, may require and investment upfront to purchase the necessary tools. Either way, clients can pay out-of-pocket for each test or service, with prices that will create a profit for nutrition providers.

Ready to expand your service offerings?

Healthie is an all-in-one practice management and EHR platform for nutrition and wellness professionals. Have all of the tools you need to run your practice, with flexible billing tools for both insurance-based practice and self-pay services. Healthie’s HIPAA-compliant features allow you to:

• Create and submit CMS1500 claims
• Safely store client credit card information
• Build and charge for self-pay services
• Review client photo-based food journal entries
• Securely message individual clients, or a group of clients
• Launch virtual group sessions