Insurance Verification Form

If you are interested in finding out your insurance coverage status, we will contact your insurance company and get back to you in 2 business days.

First Name*

Last Name*

Date of birth*

Email*

Phone Number*

Insurance Company*

Members ID number*

Group number (if any)

Phone number for provider*

Are you the primary policy holder?*

If no, please provide the date of birth of the primary policy holder.

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Xu Acupuncture Wellness

347 Fifth Avenue (34th St.), Suite 1509, New York, NY 10016

718-690-8321

Insurance Plans Accepted

We accept most major insurance companies:

Aetna
Bluecross Blueshield
Cigna
Emblem
Health first
Health Republic Insurance of NY
Magnacare
United Healthcare
Workers' Compensation
1199
Others

A superbill can be provided for your insurance reimbursement.

Payment will be rendered at time of service, check (preferred), cash, and credit card are accepted.

Xu Acupuncture Wellness P.C.

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