Policy

Medical Release

TKS Nutrition LLC would like to coordinate your care with your medical team.  Release of Medical Records will allow us to request your medical information your health care team.

HIPAA

TKS Nutrition LLC takes your privacy seriously.  We follow all required laws to ensure your information is confidential and secure.

Physician Medical Nutrition Therapy Referral Form

Some insurance companies require a referral from your physician to provided medical nutrition therapy.  You can provide a copy of the form to your physician and request they forward it to your office.  Otherwise, TKS Nutrition LLC will work to obtain it.

Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care items and services.

NOTE: The GFE does not apply currently to any clients who are using insurance benefits, including Out of Network Benefits (seeking reimbursement from your insurance companies). 

NOTE: These requirements do not apply to people with coverage through programs like Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE. These programs have other protections against high medical bills.

Beginning January 1, 2022, if you’re uninsured or you pay for health care bills yourself (don’t have your claims submitted to your health plan), health care providers and facilities must provide you with an estimate of expected charges before you get an item or service. This is called a “good faith estimate.”

This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.  

If you are billed for more than $400 of your Good Faith Estimate, you have the right to dispute the bill. 

You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. 

You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. 

There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. 

To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 1-800-985-3059.

TKS Nutrition Privacy Policy

TKS Nutrition LLC respects your right to privacy, and this policy outlines our guidelines concerning the use of your personal information, including the efforts we make to protect the personal information you provide us when you access our website, purchase our goods or services, or engage with us on social media.