Insurance Billing Information

Insurance Billing

James Whitmore, LAc is in network with:
Providence, Regence, Pacific Source, United Health Care, First Choice Health, Multi Plan, Tri West (VA), and More.

Benefits will be verified before insurance is accepted in lieu of payment.
Call (541)241-3135 for a free benefits check, or fill out the form below.

MVA (Motor Vehicle Accident):
All are are accepted with a claim number, at no cost to you.
Call us to find out more.

Workers Compensation Cases:
Accepted on a case-by-case basis, and subject to authorization by the Workers Comp Company. It is generally necessary to have a prescription from your case physician. Call us with questions, or to find out more.

Acupuncture Insurance Benefits Check Form

* Indicates required field

Name *

First

Last

Date of Birth *

Email *

Phone Number *

Preferred Communication *

Phone (most secure) Email

Insurance Company *

ID or Member # *

Group # *

Main Person on Policy? *

Yes No

Name of Main Policy Holder *

Date of Birth *

Relationship *

Submit information

Insurance Billing

Acupuncture Insurance Benefits Check Form

(541)241-3135 461 NE Greenwood Ave, Ste A, Bend, OR 97701 info@EvolutionaryMed.com