Insurance Verification

All insurance benefits must be verified by us prior to treatment. Unfortunately, not all plans within these companies will provide coverage for acupuncture benefits. The insurance companies are typically open Monday - Friday during business hours. Benefits cannot be verified after business hours. Please allow 48-72 hours for a response. If for some reason you do not hear from us within this time period, please give us a call at (718) 775-8990 and we will be happy to assist you.

Name

AS IT APPEARS ON YOUR CARD

First Name

Last Name

Phone

(###)

###

####

Email Address

Insurance Company

Blue Cross / Blue Shield

Cigna

32BJ Empire BCBS

Aetna

United Healthcare

NYSHIP - Empire Plan

Other (please write the insurance company name in the comments section below)

Member ID Number

You can find this on your insurance card. (not the group #)

Date of Birth

YYYY

Insurance Company Phone Number

Usually found on the back of your card. Please be sure to list the numbers that says, "PROVIDER SERVICES"

Comments

Insurance Verification

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