TxHarmony Acupuncture & Herbal Medicine

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Appointment details

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Reason for visit

Patient name

Email address

Phone number

Available times

Tue, Jan 25

No availabilities found on this day.

Wed, Jan 26

No availabilities found on this day.

Thu, Jan 27

No availabilities found on this day.

Fri, Jan 28

No availabilities found on this day.

Sat, Jan 29

No availabilities found on this day.

Insurance verification

Insurance Information

For insurance policies that cover acupuncture, we can verify your benefit information for you and send claims to the insurance company on your behalf. You're responsible for services that are not covered by the policy. We are in network with Blue Cross Blue Shield and United HealthCare.

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

Auto Accident? No-Fault / Personal Injury

Date of accident Please bring your authorization form to the office

Case/Claim #

Case Manager's Name

Case Manager's Phone #

Address to submit claims

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

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