Verify Insurance

VERIFY INSURANCE

• Insurance Information
• Insurance Name*
• Insurance Phone #*
• Policy Holder*Full Name
• Policy Holders*Phone Number
• Member ID #*
• Group #*
• Patient's Information
• Patient's Full Name*
• Patient's DOB*Date of birth
• Policy holder DOB*Date of birth
• Patient's Address*on File w/ Insurance Company
• Patient's Phone #*
• Presenting Substance*
• Date of last use*
• Amount of Time You Have Consumed Substance*
• Have You Been To Treatment In The Last Year*
• Amount of use*per day

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Call (888) 408-8822