Check Insurance Eligibility

If you're ready to take the first step toward recovery and rebuild your life, begin by filling out the form below. Please supply information for all required fields including your contact and insurance info. The online verification process is safe, secure, and confidential. Our admission coordinators will check your insurance eligibility and contact you with their findings so you can start treatment right away.

Call Us Today If You Need More Help
877-251-4813

Contact Info

Your Name*
Your Email*
Your Phone*

Patient Info

Patient Name*
Patient Date of Birth*

Insurance Info

Subscriber Name*
Subscriber's Date of Birth*
Last 4 Digits of Subscriber SSN*
Insurance Provider*
Insurance ID Number*
Group Number*
Insurance Phone Number*
Other Comments

The Process is Free, Easy, Effective, and 100% Confidential

Call our admissions coordinators on our 24-hour hotline at 877-251-4813.

We'll coordinate with your insurance to find the lowest out of-pocket cost, or arrange payment plan options.

Begin treatment and begin the path to recovery.

877-251-4813