About
Overview
Our Approach
Faith-Based
Clinical
12-Step Program
Community
Mission & Philosophy
Our Team
Our Location
Photo Gallery
Bless A Life
We Walk for HOPE 5K
Donate
What We Treat
Overview
Alcohol
Heroin
Marijuana
Cocaine
Prescription Drugs
Meth
Opiates
Crack
Treatment Options
Overview
Dual Diagnosis Treatment
Group Sessions
One-on-One Counseling
Trauma Therapy
Medication Management
Family Therapy
Resources
Overview
Testimonials
Helpful Links
Alcoholism
Drug Addiction
Blog
Contact
Contact Us
Verify Insurance
Bless a Life
Begin Your Recovery
(619) 797-7319
Verify Your Insurance Coverage
Home
›
Verify Your Insurance Coverage
General Information
Who Is This For?
*
Family Member
Myself
Other
Patient First Name
*
Patient Last Name
*
Patient Date of Birth
*
Subscriber Full Name
Subscriber Date of Birth
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.
Photo Upload: BACK of Insurance Card (optional)
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
Name
This field is for validation purposes and should be left unchanged.