Insurance Verification Request

All clients, prospective or current, who have new insurance, need to fill out this form so that we can tell you what will and will not be covered with your insurance. After you complete the form, we can let you know ahead of your first (or next) appointment whether we take your specific insurance plan and, if so, approximately what you will owe and what your insurance will pay. If you are a prospective client, please communicate with one of our therapists to make sure we have an opening that will work with your schedule before filling out this form. You can contact the individual therapist you’d like to see by clicking on the contact button near their picture or by calling us directly (847)754-3838.

If you are requesting Occupational Therapy and plan to use your BCBS PPO Insurance, make sure you have a Physician’s referral. An easy way to do this is to have your Physician (Psychiatrist or any other MD), Nurse Practitioner, Physician’s Assistant, or any other Medical Professional who can write subscriptions fill out our Occupational Therapy Prescription Form and make sure it’s emailed to biller@hopeheal.org or faxed to 847-550-3708.