Verify Insurance

Verify Insurance Form

Fill out the form below to verify your insurance benefits and we’ll get back to you as soon as possible. Please note that all fields are required.

FULL NAME*
First Last
EMAIL*
PHONE*
Client Information
FULL NAME*
First Last
DATE OF BIRTH*
EMAIL*
PHONE*
CURRENT ADDRESS*
DRIVERS LICENSE / ID NUMBER*
SSN NUMBER*
INSURANCE MEMBER ID*
INSURANCE GROUP ID*
Insurance Information
PROVIDER NAME*
PROVIDER PHONE*
PRIMARY SUBSCRIBER FULL NAME*
First Last
PRIMARY SUBSCRIBER DATE OF BIRTH*
PRIMARY SUBSCRIBER CURRENT ADDRESS*
PRIMARY SUBSCRIBER DRIVERS LICENSE / ID NUMBER*
PRIMARY SUBSCRIBER SSN NUMBER*
PRIMARY SUBSCRIBER INSURANCE MEMBER ID*
PRIMARY SUBSCRIBER INSURANCE GROUP ID*
Insurance Card Upload
Please upload a photo of the front and back of your current insurance card
Drop files here or

Accepted file types: jpg, png, pdf.

We’ll Bill Your Insurance

You want so badly for your son to receive treatment for substance abuse, but you’re not sure how to pay for it. We accept a wide range of insurance plans. Our admissions counselors will work with you to determine your benefits coverage. Let us speak with the insurance company on your behalf to hash out things like verification and pre-certification. You can see the list of providers we work with below.

What We Accept

We can work with any insurance provider on an out of network basis. That being said, every insurance company is unique. Below are some of the providers we’ve worked with in the past. If you don’t see yours listed, don’t be discouraged. Call our admissions team. They’ll reach out to your provider to find out the specifics of what coverage options may be available.

Testimonials

"My son is now 45 days in and thanks to the hands on attention and treatment philosophy of the counselors at Clearfork, he has a future and the sky is the limit for him. I feel Clear Fork has saved my sons life! If you have a son struggling, I strongly suggest Clearfork."

- Cindy C., Parent

"Such a beautiful place, ran by beautiful people! Anyone would be lucky to receive treatment by the cream of the crop professional team they have here!"

- Katie K.

"My communication with the staff on the other end of the phone has been just amazing. The staff at Clearfork Academy are truly concerned. There is immediate reply to communication and true understanding for the situation. Thank you for caring and professionalism."

- Amber P.

Clearfork Academy is Joint Commission accredited
with the Gold Seal of Approval®

Verify Insurance