Insurance: We're here to help!

Most of our customers (about 95 percent) qualify for insurance coverage for Liquid Hope and/or Nourish, and we can help you present the best case for reimbursement from your provider.

Our team of insurance advocates provides a FREE service for anyone using Liquid Hope and/or Nourish as their sole source of nutrition. Our process includes helping locate a DME (Durable Medical Equipment Company) that will supply and bill insurance for your purchase.

Contact our insurance team at insurance@functionalformularies.com, or call (937)433-4673. We recommend reading a bit about our process (below) before you contact us....

Please print the following forms and use the checklist (what we need from you and your doctor) to guide you through this process.

Once you have completed and collected all of the documents, please FAX ALL to (937)221-9243.

PLEASE NOTE: ALL FORMS MUST BE COMPLETED AND HAVE A PHYSICAL SIGNATURE. IF NOT, WE’LL CONTACT YOU, AND THE PROCESS WILL BEGIN AGAIN. SUBMITTING ALL OF THE DOCUMENTS WILL ENSURE YOUR REQUEST IS PROCESSED IN A TIMELY MANNER. FOR UPDATES, CONTACT OUR TEAM BY EMAIL AT insurance@functionalformularies.com.

MEDICARE

The Centers for Medicare/Medicaid have assigned a BILLING CODE of B4149 to both Liquid Hope and Nourish. The code is for "Blenderized Natural Foods with Intact Nutrients." These formulas contain natural intact protein, or protein isolates. They are appropriate for patients with a documented allergy or intolerance to semi-synthetic formulas.

Please use the following checklist if Medicare is your primary insurance. Please print the forms and use them to start the insurance process with us.

Once you have all forms completed and have collected all documents from your doctor, please fax them to (937) 221-9243.

PLEASE NOTE: ALL FORMS MUST BE COMPLETED AND HAVE A PHYSICAL SIGNATURE. IF NOT, WE’LL CONTACT YOU, AND THE PROCESS WILL BEGIN AGAIN. SUBMITTING ALL OF THE DOCUMENTS WILL ENSURE YOUR REQUEST IS PROCESSED IN A TIMELY MANNER. For updates, please contact our team by email at insurance@functionalformularies.com.

IMPORTANT INFORMATION

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


    • LIQUID HOPE
  • SID#: 2013-06012/001
  • HCPCS Code: B4149
  • Insurance Data Bank & Billing Code: 57858-0004-00**
  • NPI #: 1023427705

  • NOURISH
  • SID#: 2016-0106/001
  • HCPCS Code: B4149
  • Insurance Data Bank & Billing Code: 57858-0004-12**

DO-IT-YOURSELF-ERS ....

If you choose to do this on your own, use the checklist and download the necessary documents (above). Once you have all of your information together, contact your current DME and ask them if they will or can carry your Liquid Hope or Nourish for you, since you will be changing formula.

If your DME refuses, check our DME List to find another in your area.

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.

ADDITIONAL INFORMATION

For 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.

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.

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.

 

**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