Insurance: We're here to help!

96% of our customers qualify for insurance coverage for Liquid Hope and Nourish.

Liquid Hope and Nourish meet all food safety requirements and meet all GRAS, HACCP, CGMPS standards. Our formulas are produced in a FDA/USDA-registered facility with a USDA inspector on site.

Medicare does cover the billing code B4149 which is used for both Liquid Hope and Nourish. Medicare will cover our formulas, as long as the patient qualifies for Medicare reimbursement by being 100% tube fed and demonstrates an intolerance or allergy to other commercial enteral formulas.

Please use the following checklist to start this insurance process for all insurances: private, Medicaid and Medicare. Please print the forms, and have your physician complete the documents that they are required to complete.

 

 

Once you have all completed documents, first contact your current DME supplier and ask them if they can carry your Liquid Hope or Nourish for you, since you will be changing formula. If they cannot, please fax ALL documents to one of your state suppliers from our DME List. If there are no state suppliers able to provide the formula please reference our National DME Supplier List.

PLEASE NOTE: Make sure all forms are completed with necessary signatures. Submitting all of the documents at once will ensure your request is processed in a timely manner.

If after going through this process you are still unable to obtain Liquid Hope or Nourish please contact us for further assistance at insurance@functionalformularies.com or 937-433-4673 (HOPE).

If you need assistance with out of pocket reimbursement for purchases made previously to obtaining coverage for Liquid Hope or Nourish, Functional Formularies can direct you to an insurance advocate that can assist you with the process. There will be a fee attached to this service.

 

 

ADDITIONAL INFORMATION

If your doctor or healthcare practitioner does not understand whole-foods nutrition, functional medicine and/or the need for a whole-foods formula, we recommend hiring a Registered Dietitian or doctor who does, and can write a statement of professional opinion on your need of and potential benefit from a whole-foods diet/formula.

Liquid Hope and Nourish undergo regular nutritional assessment and lab testing. However, as with all whole-foods products, nutrient levels may vary slightly due to growing season, soil, and weather conditions. If you have a specific medical condition that requires you to be exact with certain nutrient levels, PLEASE DISCUSS THE USE OF THIS PRODUCT WITH YOUR MEDICAL TEAM.

 

 

OTHER PAYMENT OPTIONS

Check with your employer to see if you’re eligible to use your HSA (Health Savings Account) or FSA (Flexible Spending Account. Depending on whether or not your situation meets federal guidelines, your purchase(s) of Liquid Hope/Nourish might be tax-deductible as a healthcare expense.

Medicare, Medicaid and health insurers may ask you to provide a National Drug Code/NDC number for insurance claims, billing or reimbursement purposes. Because our products are whole foods and are not classified as drugs, we have an INSURANCE DATA BANK AND BILLING CODE that you should use when asked for an NDC number for our products.

 

 

BILLING INFORMATION

LIQUID HOPE
SID#: 2013-06012/001 

HCPCS Code: B4149 

Insurance Data Bank & Billing Code: 57858-0004-11

** 

NPI #: 1023427705 


Click here for a Downloadable PDF of the LIQUID HOPE PRODUCT SHEET with LONG NUTRITIONALS.

 


 

NOURISH
SID#: 2016-0106/001 

HCPCS Code: B4149 

Insurance Data Bank & Billing Code: 57858-0004-12** 


Click here for a Downloadable PDF of the NOURISH PRODUCT SHEET with LONG NUTRITIONALS.

 

 

**National Drug Codes (NDC) Format Codes: Products sold by Nutritional Medicinals LLC are not classified as Medical Foods by the US Food and Drug Administration (FDA). NDC format codes are product codes adjusted according to standard industry practice to meet the format requirements of pharmacy and health insurance computer systems. NDC- format numbers have been submitted by Nutritional Medicinals LLC to data warehouses. While Nutritional Medicinals cannot confirm that NDC-format numbers have been published, the codes listed are based on the formatting established by NDC data warehouses but does not guarantee reimbursement.

 

 

© 2017 Nutritional Medicinals, LLC