PAYING WITH INSURANCE:
• If you'd like to pay with insurance, please fill-out your insurance information. We will inform you of your acupuncture benefits on the day of your appointment.
• As a courtesy, we will bill your insurance carrier. However, it must be understood that the contract is between you and your insurance and you are fully responsible for any amount that they do not pay, including deductibles and co-insurance.
• Verifying benefits is not a guarantee of payment. If for any reason a submitted claim is denied by your insurance, you will be responsible to pay the full billed amount.
• Co-pays will be due at time of service.
• By initialing here, you agree to the release of medical and billing information necessary for treatment, payment and healthcare operations and assign benefits payable to Venn Acupuncture and/or Claudia Venn