Insurance Verification

Find out if you qualify for $10 Co-Pay treatments

As you know health insurance plans vary greatly in what they cover, much like auto insurance.

By filling out this form, we will be able to verify: that Kirk is an In Network provider with your insurance plan, if your deductible has been waived because of that, also how many treatments you are entitled to per year (calendar or start date), what your co-pay is, and if there are any restrictions on treatment in your policy.

Kirk and his billing company will get copies of this information only. His billing company will do their best to research your information and email Kirk that data within 2 business days. Kirk will then call you with all the details, and answer any questions. If you have not heard from us promptly, please send us a note. If time is of the essence, please state that in the comment box at the end.

We look forward to being of service to you. We pride ourselves on our high success rate and candid connected nature. See why all our Yelp reviews are 5 stars.

American Specialty Health (ASH): If you have ASH insurance, please note you’ll be covered for the first 15 minutes of acupuncture treatment only. If you want additional services, they will come with an additional charge.

All Scripps, Kaiser and Sharp health plans utilize ASH.

For a list of all services, click here.

Name*
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First Name
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Last Name*
Phone*
Email*
Insurance Company*
Membership ID*
Date of Birth*
Member Services Phone Number
Please enter the member services phone number on the back of your insurance card. This helps us to contact the right department when verifying your insurance.
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