We work with PPO, EPO and HMO Health Insurance Plans

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Verify your PPO health-medical insurance plan pays for residential drug treatment serviceThe form below is intended to streamline the medical insurance verification process for you.  We realize you have quite a lot going on right now and the last thing you need to concern yourself with is the headache of having to deal with your insurance company.  Once submitted, your confidential information will immediately be sent to our utilization review team, which specializes in dealing with all type of health insurance plans and companies.

In most cases we are able to complete the verification process within an hour or two, at which point our team will contact you to go over everything, including the next steps to be taken.  For immediate assistance please call us at (877) 724-7472 or send us a text to (949) 324-6132.

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PPO, HMO or EPO Health Insurance Plans Accepted
Drug / Alcohol / Dual Diagnosis
Medical Detox, Rehab Intervention

Send a picture of the front and back of your insurance card
Text: (949) 324-6132
Email: info@wirecovery.com
Or complete the confidential insurance verification form below
A counselor will call you shortly

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For immediate assistance call tool free (877) 724-7472


Patient Name:*
E-mail:
Phone:*
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Address:
Gender:*
Date of Birth:*
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SECTION 2: Enter insurance information below...

Primary Insured name (if applicable):
Primary Insure Email (if applicable):
Primary Insured Phone (if applicable):
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Primary Insured Address (if applicable):
Primary Insured Gender (if applicable):
Primary Insured DOB (if applicable):
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Last 4 of SS#
Insurance Company Name:*
Insurance Phone #*
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ID #*
Group #
Plan Type:*
Additional Details:
Word Verification:


All information submitted is kept 100% confidential in accordance with federal HIPAA mandates. Upon submission this information will be sent to our health insurance authorization team for immediate processing...



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Southern California Addiction Treatment

WITS INN • Addiction Treatment for All!

Orange County • Southern California

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