Insurance Verification

Whole Body Mantra accepts any insurance that covers out-of-network acupuncture services.

Coverage varies from policy to policy. Please complete the form below so that we may contact your insurance provider to obtain the details of your exact coverage. All information submitted via this website is confidential. Policies vary widely and it is important to fully understand the following when researching coverage:

  • Whether you are covered
  • Whether your policy limits the number of visits per year
  • Whether your policy limits the types of ailments it covers
  • What your deductible is and whether it has been met
  • What percentage of the cost your insurance company will cover

Once you have completed this form, we will contact you within 2 business days outlining the details of your coverage. All payment is due at the time of service until coverage is verified. 

 

Please complete the form below

Patient Name *
Patient Name
Please provide the name of the individual seeking to verify insurance coverage.
Policy Holder Name
Policy Holder Name
Please provide the name of the primary policy holder if different from that of the patient.
Patient Date of Birth *
Patient Date of Birth
Address *
Address
Blue Cross Blue Shield, United Health, Aetna, Cigna, etc.
Please include all numbers and letters.
Please include all numbers and letters.
Insurance Company Phone # *
Insurance Company Phone #
This phone number is usually listed on the back of your insurance card.
Please let me know if you have any further comments or questions.