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Nutricia Coverage Department

Nutricia understands that getting reimbursement for medical foods and exempt infant formulas is important to many families and individuals living with a metabolic disorder. It may also influence medical decisions and the ability to maintain diet for life.

We offer a specialized coverage department to help you navigate your insurance and Medicaid plans to verify eligibility, confirm benefits and find a supplier. Our team of coverage specialists will guide you, from start to finish, through the medical food coverage and reimbursement process.

The Nutricia Best Care Coverage Team can provide personal assistance with:

  • Obtaining prior authorization for any and all Nutricia products, such as Periflex, Lophlex, PhenylAde and other Metabolic products
  • Answering questions regarding Medicaid or claims submissions
  • Verify eligibility and confirm benefits
  • Instructions on how to correct billing errors
  • Find in-network supplier to fulfill formula needs
  • Appealing a denied claim  
  • ...and much more!

Call 1-800-605-0410 or email Coverage@MedicalFood.com today to start receiving personalized assistance with your insurance coverage matters.

 

Coverage Tips      Get Started Form      FAQs

Letters of Medical Necessity

A Letter of Medical Necessity is certification by a physician that the prescribed item(s) is/are medically indicated, reasonable and necessary with reference to the standards of medical practice and treatment of a patient’s condition.

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How to Order

How to order Nutricia products online, by phone, or through a pharmacy. In addition, find information for ordering in Canada and outside North America.

 

 

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Coverage by State

Which states are required by law to cover metabolic formula. Here you will find an interactive map to aid you in learning more about coverage in your state.

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Reimbursement Codes

Use this helpful chart to find product packaging details, HCPC and reimbursement codes, plus other helpful ordering information.

 

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