Insurance for Online Addiction Treatment

Health Insurance - Online Addiction Treatment

Online Addiction Treatment is an out-of-network provider working with many of the nation’s most highly respected health insurance plans.

In doing this we are able to provide those seeking our unique substance abuse treatment services with an affordable alternative to many high-priced virtual addiction treatment programs.

We have staff on-hand 7 days a week in order to immediately begin processing health insurance authorization. We encourage you to complete the confidential insurance verification form below.

Insurance Verification Form

Patient Information
Patient Name*
First Last
Patient Social Security Number
Patient Date of Birth*
MM slash DD slash YYYY
Patient Address*
Street Address City State ZIP Code
Patient Phone*
Patient Email*
Subscriber Information
Please complete the following "subscriber" information if different than the "patient" information entered above.
Subscriber Name
First Last
Subscriber Date of Birth
MM slash DD slash YYYY
Subscriber Address
Street Address City State ZIP Code
Subscriber Phone
Subscriber Email
Insurance Information
Plan Type*
- PPO
Insurance Company*
ID Number*
Group Number*
Insurance Phone Number for Health Care Providers*
Additional Information
CAPTCHA

Insurance for Online Addiction Treatment

Insurance Verification Form

Patient Information

Subscriber Information

Insurance Information