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Insurance Coverage

Complete the Form

What you need to get started:
Health Insurance Card

Our team of specialists will do the necessary research to run a no-cost, private approval of your specific policy. If you have coverage of any kind from a major insurance provider, your treatment is likely covered. We promise to keep your information confidential.

  1. Fill out all of the fields on the confidential form
  2. A member of our staff will contact your insurer to verify if your policy will cover your treatment
  3. We will contact you within an hour with the results of the verification and discuss next steps

Policyholder Information

Found on the back of the insurance card
Address Associated with the Policy *
Address Associated with the Policy
Address 1
Address 2
City
State/Province
Zip/Postal
Are You the Primary Policyholder? *

*Insurance Disclaimer

  • ASIC Recovery will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization.
  • We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service.
  • Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” We will make every effort to have all services preauthorized by your health insurance company.
  • If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.
  • ASIC Recovery accepts insurance from most major providers.