We Accept Most Major Insurances

Providing affordable professional behavioral health care to you.

Send Us a Message

Fill out the form below, and one of our team members will get back to you as soon as possible.

Surest Health Insurance

Surest Health Insurance Coverage of Addiction Treatments Finding the right journey for addiction treatment can be exhausting, especially with many questions that always come up when it comes to insurance coverage of these services. Surest Health insurance helps with a...

Verify Your Insurance Coverage

General Information
Who Is This For?*
Patient Full Name
First Last
Patient Date of Birth*
Patient Social Security #
Subscriber Full Name
Subscriber Date of Birth
Subscriber Social Security #
Email*
Home/Cell Phone Number*
How did you hear about us?*
Address
Address on file with your insurance carrier.
Street Address*
City*
State*
Zipcode*
Insurance Information
Insurance Carrier*
Insurance ID #
Provider Services Phone # (on back of card)*
Group ID #
Type of Plan
- PPO
- HMO
- EPO
- POS
- Unknown
Is this a COBRA Policy?
- Yes
- No
- Unknown
Photo Upload: FRONT of Insurance Card (optional)
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.
Photo Upload: BACK of Insurance Card (optional)
Max. file size: 50 MB.
Additional Information
Have You Been to Treatment Before?
Brief Description of Your Problem
Comments
When and how is the best way to contact you?
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

We Accept Most Major Insurances

Send Us a Message

Surest Health Insurance

General Information

Address

Insurance Information

Additional Information

Pin It on Pinterest