Insurance Verification

To verify that your insurance benefits will cover your substance use disorder treatment at Mile High Recovery Center simply fill out the form below or give us a call at 855.796.2102 to get the process started. Our admissions team aims to make the insurance verification process as quick and easy as possible.

Your Contact Information
Your Name*
FirstLast
Return Callback Phone Number*
Email*
Who is seeking treatment?*
- Yourself
- A Loved One
How Did You Hear About Us?
Loved Ones Information
Your Information
Loved Ones Name*
FirstLast
Loved Ones Date Of Birth*
MM slash DD slash YYYY
Your Date Of Birth*
MM slash DD slash YYYY
Additional Information
Insurance Information
Would you like us to verify your or a loved ones insurance benefits?*
- Yes
- No
Policy Holders Name*
FirstLast
Policy Holders Date Of Birth*
MM slash DD slash YYYY
Policy Holders Address**
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Insurance Company's Name*
Insurance Company's Phone Number*
Member ID*
Group Number*
Subscriber relationship to client*
CAPTCHA
Consent*
I agree for Mile High Recovery Center to store my data for use only within the context of this form and understand that my data will never be sold, shared or used for anything other than to help you with your inquiry as set out in our Privacy Policy

Insurance Verification

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Your Contact Information

Loved Ones Information

Your Information

Insurance Information

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Substance Abuse Treatment

Addiction Therapies