At Functional Formularies we have patient advocates available to help assist you in gaining insurance coverage for our products. Please email us at: firstname.lastname@example.org or call us at 937.433.HOPE (4673) and we will set up an appointment for you with a patient advocate.
96% of our customers qualify for insurance coverage for Liquid Hope and Nourish.
All of our products, Liquid Hope, Nourish, Liquid Hope Peptide, Nourish Peptide and Keto 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.
Medicare also covers the billing code B4153 for adults (Liquid Hope Peptide & Keto) and B4161 for pediatrics (Nourish Peptide & Keto). Medicare will cover these formulas, as long as the patient qualifies for Medicare reimbursement and is being 100% tube fed and demonstrates a need for a peptide formula.
You may find the following checklist and forms helpful in working through the 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 prescribed formula for you (Liquid Hope, Nourish, Liquid Hope Peptide, Nourish Peptide or Keto), 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.
If you would like assistance with any part of this process, please let us know and we will have our Patient Advocate contact you to provide assistance.
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 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.
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.
HCPCS Code: B4149
Insurance Data Bank & Billing Code: 57858-0004-11**
NPI #: 1023427705
HCPCS Code: B4149
Insurance Data Bank & Billing Code: 57858-0004-12**
** 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 do not constitute "drugs", we have an Insurance Data Bank and Billing Code that you should use when asked for an NDC number for our products.