Directions: You may use your phone, tablet, or computer to complete this form. To get started, you'll need your insurance card and photo ID. Once you've finished filling out the form, you'll need to take photos of both cards and upload them before you submit. When you have your insurance card and ID in hand, click Next to continue.
Each provider has different circumstances when it comes to insurance. Some don’t accept insurance, some accept a few plans, and some accept many.We have a limited number of providers who are fully credentialed with insurance. This means if you wish to utilize your insurance, you may be added to a wait list until one of our providers has an opening for an insurance-based client. The wait could be a month or longer. If you are in a crisis or need urgent care, we recommend paying out-of-pocket until we have an opening or seek out other in-network providers in your area.
Submission of this form will authorize Medens Health to verify your mental health eligibility and benefits, including any copay and deductible. Results are typically available within one to two business days.
If you have any questions contact your provider or send us a message at email@example.com.