What are clinical visit guidelines?
Clinical Visit Guidelines ensure consistent and effective care. Initially piloted with County Care Members, use of these guidelines will expand to other health plans once they are refined.
The guidelines are crafted to navigate Members through their Member Care Journey, offering a structured framework for Dietitians to effectively support and educate them. They detail the total number of visits and the frequency/cadence of those visits (e.g. every two weeks, once per month, etc), based on their health condition(s), with an overall goal of supporting health outcomes and meeting payer requirements/outcomes.
When we follow these guidelines, members become healthier, RDs provide more impactful, and engaging care, and payers see the clinical Return On Investment (ROI) they expect. Ultimately, this leads to more meaningful work for you and more Members to fill your schedule.
Our new evidence-based guidelines, informed by the Academy of Nutrition and Dietetics (AND), bring structure and clarity to visit scheduling. This structured approach not only improves Member outcomes but also helps optimize the use of clinical resources, ensuring that every visit is purposeful and impactful.
In addition to improving visit frequency, the Clinical Visit Guidelines emphasize the importance of personalized care. Each Member’s unique circumstances, health goals, and progress are taken into account, allowing for a more tailored and effective care plan. This personalized approach fosters stronger Member engagement and satisfaction, ultimately leading to better health outcomes and a more efficient care delivery system.
Where do you see clinical visit guidelines?
These guidelines are accessible within a Member’s chart once a medical condition is selected, removing the need to search FNN for health plan visit details.
When scheduling a visit, FFD will automatically present the recommended visits and frequency tailored for that Member.
**The condition-specific guidelines are designed to support your clinical judgment rather than serve as strict rules.
**Dietitians have the flexibility to determine the best course of action for their Members, while the system provides clear and straightforward guidance throughout the process.
**Visits exceeding the limits set by the plan will still be restricted from scheduling.
List of qualifying conditions for the condition visit guidelines:
AIDS
Celiac disease
CKD
Diabetes
Gestational Diabetes
Type 1 Diabetes
Type 2 Diabetes
End-stage renal disease (ESRD)
Heart Failure
High cholesterol
HIV
Hypertension
Hypertension Pregnancy-induced
IBS
Malnutrition
Obesity
Obesity Child
Overweight
Prediabetes
Preeclampsia
Pregnancy Ulcerative Colitis
How to select a medical condition?
Start the visit
Select at least one medical condition
After starting the visit, select a medical condition to automatically generate clinical visit guidance for your Member.
Multiple medical conditions can be selected. Foodsmart for Dietitians will automatically prioritize the conditions with the highest number of permitted visits.
Upon selecting a medical condition(s), clinical visit guidelines will automatically update to reflect the recommended number and cadence of visits in real time. However, the total number of visits completed out of total number allowed by the insurance plan will update once the chart encounter is completed and finalized
Currently, Clinical Visit Guidelines are only available for County Care members.
You will not see clinical visit guidelines for other health plan members at this time, but that is on the roadmap.
Foodsmart for Dietitians Member Management Page
Click on the down arrow next to the Member's name to easily view their Clinical Visit Guidelines.
Expand the View program schedule section for a comprehensive overview of the Clinical Visit Guidelines.
Having a clear understanding of these guidelines will allow you to facilitate the scheduling of follow-up appointments, ensuring that each Member receives the necessary support and continuity of care.
This proactive approach not only improves Member satisfaction but also optimizes the overall management of their health journey.
How to apply the Clinical Guidelines?
Many Members come to Foodsmart not just to learn about healthy food, but because they can't afford to purchase it. They could be experiencing food insecurity or are struggling with the rising cost of groceries.
That’s where our tools make a real difference. Foodsmart Bucks, Medically Tailored Meals, and SNAP support are powerful ways to help Members get access to nutritious food quickly and effectively.
What is the dietitian's role?
Use Clinical Guidelines
Integrate current, evidence-based standards (e.g., ADA, AHA, AND guidelines) into your assessment and care planning to ensure safe, effective, and individualized nutrition care.
Set clear, measurable goals
Use your MNT expertise and Foodsmart tools to guide meaningful behavior change.
Work with the Member to co-set SMART goals–Specific, Measurable, Achievable, Relevant, and Time-bound–that align with their readiness, lifestyle, and values.
Follow Up Visit Guidelines
Schedule and document follow-up visits according to Foodsmart’s clinical visit protocols to track progress, reassess goals, and maintain continuity of care.
Follow Up Cadence
CADENCE is crucial: for instance, if a plan allows for only three visits and the primary goal is to achieve a reduction in A1c, scheduling the visits at week 1, week 2, and week 3 will not provide sufficient time to demonstrate a meaningful change in A1c levels. To effectively show progress, the first and third visits should be spaced at least three months apart, as this aligns with the frequency at which A1c is measured.
What is medical necessity?
Medical Necessity defines when care is clinically appropriate and justified for a Member’s condition or health goals. Providing and documenting care that meets Medical Necessity standards ensures both quality care and proper reimbursement.
Care is medically necessary when it:
Treats a diagnosed condition
Prevents worsening of a chronic illness
Improves function or quality of life
(e.g., better glycemic control, improved food access, reduced blood pressure, or enhanced nutritional intake)
Accurately charting Medical Necessity supports not only reimbursement but also outcome measurement and the demonstration of our programs effectiveness.
What is the dietitian's role with medical necessity?
Connect MNT to Diagnosis
Medical Nutrition Therapy (MNT) must always be tied to a diagnosed condition associated with nutrition (e.g., diabetes, hypertension, obesity, malnutrition, gastrointestinal disorders).
Document Medical Necessity
Ensuring each visit reflects Medical Necessity protects the integrity of care, supports Member outcomes, and aligns with Foodsmart’s mission.
Tying it back to clinical outcomes
When you understand what matters to the Member and deliver care that aligns with their needs and motivations, outcomes will follow:
A Member who comes to their first visit for Foodsmart Bucks but stays for better blood sugar control
A parent who came for food support but stays to improve family nutrition
A Member who felt seen and supported—and kept returning until their A1c dropped, their weight decreased, or their blood pressure stabilized
Our role as Dietitians is to inspire Members to engage with us in addressing these health challenges. Therefore, it is important not to turn away those who initially seek only food support.
When is care no longer medically necessary?
Dietitians may decide to discontinue or pause care if:
The Member has achieved their clinical goals
The Member’s progress has plateaued and further care is unlikely to result in improvement
The Member is no longer engaging in a way that allows for clinical progress (despite best efforts)
The Member does not have a qualifying condition and is seeking care only for the incentive, with no intent to engage in meaningful behavior change
Using Clinical Visit Guidance empowers Dietitians to effectively guide Members through their health journey.
Together, we can make their Foodsmart experience seamless, impactful, and truly transformative, helping them graduate to healthier, sustainable habits.