Verify Insurance

Does Your Insurance Cover Treatment?
Find Out if You’re Covered

We can simplify the health insurance coverage process by verifying your insurance benefits with our confidential insurance verification form. Once you’ve finished submitting the private form, one of our caring treatment specialists will call you shortly to connect you with the care you need. We are also happy to work with your health insurance provider to help make the process easier.

First Name *

Last Name *

Email Address *

Phone Number *

Patient Address *

Patient Address Line 2

City *

State *

Zip Code *

Patient Date of Birth *

Patient Last 4 SSN *

Primary Insured First Name *

Primary Insured Last Name *

Primary Insured Last 4 SSN *

Primary Insured Date of Birth *

Primary Insured Email Address *

Primary Insured Phone Number *

Insurance Provider Name *

Insurance ID Number *

Insurance Group Number *

Insurance Company Phone Number *

Insurance Type *

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Verify Insurance

Does Your Insurance Cover Treatment?
Find Out if You’re Covered

Build your foundation for recovery

CALL NOW

About WORC

Treatment

Admissions

Verify Insurance

Does Your Insurance Cover Treatment? Find Out if You’re Covered

Build your foundation for recovery

CALL NOW

About WORC

Treatment

Admissions

Medical Disclaimer:

Does Your Insurance Cover Treatment?
Find Out if You’re Covered