Mackay Rippey Acupuncture Insurance Verification

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(315) 557-6892

Insurance Verification

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Patient's Email

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Insurance Verification

Verification Urgency

Contact Me By

Patient Information

Employer's Name

First Name

MI

Last Name

Social Security Number

Date of Birth

Gender

Male Female Others

Preferred Method of Contact

Patient's Phone Number

Patient's Email

Chief Complaint / Primary Diagnosis

Address Line 1

Address Line 2

City

State

Zip Code

Insurance Information

Insurance Company Name

Phone

Policy Number / ID Number

Relationship to Insured

Group #

Policy Holder First Name

PH MI

Policy Holder Last Name

Policy Holder DOB

Subscriber # / ID #

Claim # if an Accident

Date of Accident / Injury

Additional Documents

Upload Document

Accepted file types : pdf, jpeg, jpg, png, gif.

Success

Mackay Rippey Acupuncture

87 Utica Road

Clinton NY 13323

(315) 557-6892

Insurance Verification

Patient Information

Insurance Information

Additional Documents

Create Patient

Patient

Change Password

Profile

Mackay Rippey

Male

Address

Email

Phone

Success

Insurance Verification

Patient Information

Insurance Information

Additional Documents

Create Patient

Patient

Change Password

Profile

Mackay Rippey

Male

Address

Email

Phone

Success