Insurance Verification Form

The expense of addiction and mental health treatment should not be prohibitive - nor should it prevent you from gaining admission at a top treatment center. That is why Embodied Recovery accepts several PPO insurance plans as payment for drug and alcohol treatment. Please fill out the insurance verification form below to verify your insurance benefits. A team member will give you a call back within 24 hours. If you have questions about the providers we partner with or how to get your insurance to pay for addiction treatment,

Call us at 888-372-3610

1-888-372-3610

Insurance

Name of Participant:*
First Last
How Did You Find Embodied Recovery?
I need help with:*
- Mental Health
- Addiction
- I'm not sure
Date of Birth:
Participant Address:
Participant Contact Number:*
Participant Email:*
Primary Policy Holder:*
Primary Policy Holder DOB:
Primary Policy Holder's Address:
Primary Policy Holder's Contact Number:*
Insurance Company:*
Insurance ID:
Insurance Provider's Number:
Group #:
Is there anything we should know before contacting you?

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