AcuWell LLC

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Appointment details

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Reason for visit

Patient name

Email address

Phone number

Available times

Fri, Sep 25

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Sat, Sep 26

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Sun, Sep 27

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Mon, Sep 28

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Tue, Sep 29

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Wed, Sep 30

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Thu, Oct 1

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Fri, Oct 2

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Sat, Oct 3

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Insurance verification

Insurance Information

We are in-network with Blue Cross Blue Shield and United Healthcare/Optum. To verify insurance coverage, please submit the required information and we will call you with your coverage details as soon as possible. If you are covered by a different carrier, you may be eligible for reimbursement from your insurance company for our services. We also accept FSA/HSA plans.

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

Text me a reminder and other helpful updates*

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