Verification of Benefits
Verification of Benefits

Did you know that insurance often covers substance abuse and mental health treatment services? We accept most private PPO health insurance plans, are a preferred provider with Anthem Blue Cross HMO, and can verify your insurance coverage details for you at no cost or obligation.

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optum united healthcare logo
Confidential Insurance Benefits Verification Form
Please note: At this time we do not take Medicare, Medi-Cal or Cen-Cal plans.
Insured Name

* Required

Email

* Required

Insured DOB
Phone

* Required

How did you hear about us?
Who is seeking treatment?
Insurance Provider

* Required

Type of Insurance

* Required

Member ID
Don’t See Your Insurance Provider Listed?
Do not be discouraged if you are not seeing your insurance provider listed on our website. We take many types of insurance, and you may still qualify for coverage. Please fill out our benefits verification form and we will be in contact shortly with program and pricing options.
Questions about Coverage?
For a Confidential Assessment CALL or TEXT
**At this time we do not take Medicare, Medi-Cal or Cen-Cal Plans