Insurance Verification Form

To determine you Eligibility to pay for drug and alcohol Treatment Services please enter your information below so we can let you know what services and providers are covered.

Please allow us 24 hours to make that determination.

If you would like to use your Health Insurance for drug and alcohol Treatment please enter your information below and we will let you know which services and providers are covered or feel free to call our administrator with any questions.

Call Toll Free: 1-855-99-PARTNER (855-997-2786)
Our insurance billing department is open Monday through Friday 9 am to 4 pm PST
Red fields below are required.

In compliance with HIPPA regulations, we may only contact you regarding confidential health matters in ways that you explicitly authorize. By providing the above contact information, you are authorizing us to contact you via that method. The more ways we have to contact you, the more quickly you can get your answer. For your privacy, select the method least likely to be checked by other parties. By submitting this form, you are explicitly authorizing us to use the information supplied to contact your insurance provider for the purpose of verifying eligibility for insurance benefits for the purposes stated above. The above information will also be used by an Admissions Counselor at Sober Partners Network to provide you with treatment options. Under no circumstances will your confidential information be shared with third parties or used for any purpose other than stated herein.