We accept most insurances out of network*. We can verify your benefits and calculate your co-pay, usually within 90 minutes during standard business hours.
*Senders Name (required):
*Spenders Email (required):
Senders Phone Number:
Patient Date of Birth:
Insurance Subscribers Name (if different than patient):
Date of Birth (if different then patient):
Primary Insurance Carriers Name:
Group ID Number
Member ID Number
Policyholder Employer The Group Plan Is Under:
Insurance Companies Phone Number:
Please leave this field empty.
*unfortunately Medicaid and Medicare do not cover our treatment services.