Zoetic Acupuncture

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Patient name

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Phone number

Available times

Wed, Sep 22

No availabilities found on this day.

Thu, Sep 23

No availabilities found on this day.

Fri, Sep 24

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Sat, Sep 25

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Insurance verification

Insurance Information

We are currently an in-network provider for Blue Shield of California, OptumHealth, and UnitedHealthCare. We will verify your insurance coverage (both in- and out-of-network) for free. Please fill out the Insurance Verification Form at http://www.zoeticacupuncture.com/new-patients.html or email us at info@zoeticacupuncture.com and provide us with the following information: • Insurance company name • Member ID • Date of birth Please allow 48 hours for verification.

If you want to use insurance for your visit please fill out the fields below so that we can verify your coverage

Name of Primary Insurance (Blue Cross, Aetna, Anthem etc.)

Insurance Type (HMO, PPO etc.)

ID # on insurance card The ID number on your insurance card

Group number

Insurance Provider Phone Number Located on back of insurance card

Claim address Located on the back of insurance card

City

ZipCode

State

Covered under someone else's insurance plan? Select "yes" if you are covered under someone else's insurance

Patient relationship to insured

First Name of Insured Party First Name of the primary policy holder

Middle Name of Insured Party Middle Name of the primary policy holder

Last Name of Insured Party Last Name of the primary policy holder

Insured Party Date of Birth Date of birth of the primary policy holder

I have read and accept the Terms of Use and Privacy Policy

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