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  • VOB

    20$
    +$0.75 credit card fee
    Verification of Benefits
    Valid for one month
    • To help ensure services that are rendered will be covered
    • Please Note: ALL SALES ARE FINAL

  • OON Requests

    25$
    +$0.90 credit card fee
    GAP Exception/Single Case Agreements
    Valid for one month
    • GAP Exceptions and Single Case Agreements are requests for
    • in-network benefits for services provided by an out of
    • network provider.
    • PLEASE NOTE ALL SALES ARE FINAL

  • Superbill Request

    40$
    +$1.50 credit card fee
    Per Superbill
    Valid for one month
    • Claim is filed with your insurance company directly via
    • paper or electronically. This service does not include
    • following up on the claim. Claim follow up is the patients
    • responsibility. Please Note: All sales are final.

  • Insurance Appeals

    40$
    +$1.50 credit card fee
    Per Insurance Appeal
    Valid for one month
    • Assistance with appealing claim denials with insurance.
    • PLEASE NOTE ALL SALES ARE FINAL
Pricing: PaidPlans

                               Patient Contact Form

                         Insurance Verification/GAP Exeptions/Single Case Agreements/Superbill Request/Appeals

Please fill out the following form

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