Insurance Verification
Please fill out all fields and allow for 3 business days for a response. 
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Email *
Note: insurance benefit information is a courtesy service and ultimately is the patient responsibility to know and understand their plan benefits. Having acupuncture benefits does not guarantee coverage for a billed service. Insurance companies reserve the right to deny any claim. 
Name (First Name, Last Name) *
Date of Birth (MM/DD/YYYY) *
Name of Subscriber (First Name, Last Name) *Person financially responsible for coverage if different from querent
Subscriber Date of Birth (MM/DD/YYYY) *If different from querent
Insurance Company Name  *
Plan ID Number (Please note this is NOT the group number) *
Insurance Company Phone Number (If the back of the card has multiple numbers please submit the PROVIDER number) *
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