Check Your Insurance Benefits

Many insurance plans do have acupuncture benefits. Our billing team is happy to check your coverage for you. I am an in-network provider for all Cigna PPO and HMO plans. I accept most other PPO’s as an out-of-network provider. I do not accept any plans contracted through American Specialty Health (ASH).

Please submit your insurance information 72 hours before your first appointment. All information is kept strictly confidential and will only be used for verification purposes with your insurance company.

Name

First Name

Last Name

Email Address

Phone Number

(###)

###

####

Full Date of Birth

YYYY

Insurance Carrier

Member ID #

Insurance Customer Service No.

Usually found on the back of the card

(###)

###

####

Name of Main Policy Holder (if different)

First Name

Last Name

Full Date of Birth of Main Policy Holder (if different)

YYYY

Additional Comments or Questions

Check Your Insurance Benefits

Please submit your insurance information 72 hours before your first appointment. All information is kept strictly confidential and will only be used for verification purposes with your insurance company.

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