Acupuncture Benefits Form

Find out if Your Health Insurance Plan Covers Acupuncture Treatments

Filling out this form provides us with the necessary information to call and determine your insurance eligibility for acupuncture treatments. Please, be advised that the information we receive during this call concerning your out-of-pocket expense could be different from the actual payment required. Only when we receive an Explanation Of Benefits (EOB) report will we know for certain what your financial responsibility will be. It usually takes 30 days for the first EOB to arrive in the mail. The information you provide will only be used to determine your insurance coverage for acupuncture. We respect your privacy.
  • Please enter the phone number listed on the back of your insurance card .
  • Please provide your phone number so we can contact you with any questions.

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