Guide to Outpatient Nutrition Services

• Where are Nutrition Services Provided

• Who Should Provide Nutrition Services

• Basic Nutrition Services Your Clinic Staff Can Provide

• Which Patients Should be Referred to Nutrition Counseling Clinic

• How Do You Refer a Patient to Nutrition Counseling Clinic

• Does Insurance Cover Appointments in the Nutrition Counseling Clinic

• What Services and Interventions are Provided by the Registered Dietitian

Where are Nutrition Services Provided?

UCSF Nutrition Counseling Clinic (NCC)
The UCSF Nutrition Counseling Clinic at 400 Parnassus (A435) is staffed by Registered Dietitians to provide individual nutrition counseling appointments for adults, adolescents and children. Patients are seen by appointment only and a physician’s referral is required. For more information or to make an appointment, call 353-2291. Patients may also contact the ACC Call Center for an appointment, 353-4174. If insurance preauthorization is needed, please wait for authorization before making an appointment.

Please note that health insurance plans often do not include nutrition counseling as a covered service. Preauthorization is required when nutrition counseling is covered by insurance. Patients should be aware there is a fee for nutrition counseling if it is not covered by their insurance policy.

Clinics with Scheduled Coverage by a Registered Dietitian
Registered Dietitians also have established hours in selected clinics with a high proportion of patients likely to be at nutrition risk or clinics with patients who are treated with medical nutrition therapy. Patients may also be referred to the Nutrition Counseling Clinic. A written referral is required regardless of the location of the RD appointment. Clinics with a Registered Dietitian on site include:

Other Nutrition Resources at UCSF

• Weight Management Program. Call 353-2105 for information
• Diabetes Teaching Center. Call 353-2266 for information.

Mount Zion locations may be selected if the location is more convenient for the patient.

• Nutrition Counseling Clinic (request an appointment at Mount Zion) Call 353-2291.
• Cancer Resource Center at Mount Zion. Call 885-3693
• Breast Care Center at Mount Zion (for patients with breast cancer). Call 885-3700.

Off Site Nutrition Services for Some Patients
Certain patients receive care at other sites where the services of a Registered Dietitian would be available. In general, these patients would not require a referral to the Nutrition Counseling Clinic. Examples of off site programs are:

• Women, Infants and Children’s Supplemental Food Program (WIC). Low-income pregnant or lactating women, and children 5 years old or younger with a medical or nutrition risk may be referred to a WIC clinic for nutrition education and food vouchers.
• Chronic Dialysis. Patients with end stage renal disease who undergo dialysis treatment would receive nutrition care from the Registered Dietitian who is employed by the dialysis center used by the patient.
• Adult Day Health Centers.General nutrition screening and nutrition education are provided at Adult Day Health Centers.
• UCSF Home Care and other home care providers. The services of a Registered Dietitian are provided when medically indicated for patients who receive home care services.
• Skilled Nursing Facilities. Registered Dietitians at SNFs provide nutrition screening, nutritional assessment, on-going monitoring of nutritional status and medically prescribed diets.

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Who should provide nutrition services?
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Basic Nutrition Services Your Clinic Staff Can Provide
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Which patients should be referred to Nutrition Counseling Clinic?
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How do you refer a patient to Nutrition Counseling Clinic?

A written physician's referral is required. The referral form can be downloaded from the Outpatient Nutrition Services website and is also kept at each clinic location. The referral can be brought directly to NCC's mailbox in General Medicine A or B, or sent by campus mail to Box 0310. NCC should receive the referral before an appointment is scheduled.

Once the referral has been made, the patient may schedule an appointment through the Call Center 415-353-4174, or directly with the Nutrition Counseling Clinic (NCC) at
415-353-2291.

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Does insurance cover appointments in the Nutrition Counseling Clinic?

Nutrition counseling is often not covered as an insurance benefit. The patient should be informed that he/she may be required to self-pay if their insurance does not authorize nutrition counseling.

If the patient has Brown & Toland coverage, the referring clinic or the Nutrition Counseling Clinic should submit a request for authorization to B & T. Brown & Toland often covers nutrition counseling for weight management, cholesterol lowering diets, and sometimes diabetes management. If the patient has other insurance, the patient is primarily responsible for obtaining authorization from the insurance company. Authorization should be confirmed in writing before an appointment is scheduled in the Nutrition Counseling Clinic.

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What services and interventions are provided by the Registered Dietitian?

The Registered Dietitian provides nutrition assessment and counseling based on the patient’s individual needs. This includes evaluation of current intake and advice for improving the nutrient content of an individual’s diet, and medical nutrition therapy. Medical nutrition therapy involves the assessment of the nutritional status of patients with a condition, illness or injury that puts them at nutrition risk. This includes review and analysis of medical and diet history, laboratory values, and anthropometric measurements. Based on the assessment, a nutrition care plan is developed to manage the condition or treat the illness or injury. The plan generally includes the following: (1) Diet modification and counseling leading to the development of a personal diet plan to achieve nutritional goals and desired health outcomes. (2) Specialized nutrition therapy including recommendations for supplementation with medical foods or nutrient supplements for those unable to obtain adequate nutrients through food intake only.

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