Verify Insurance

Prefer to verify your insurance over the phone?

Get your insurance card ready and give us a call.

"*" indicates required fields

Patient Information

(The person in need of treatment)

Patient Name*

First Name Last Name

Patient Date of Birth*

Contact Information

Contact Name

First Name Last Name

Phone*

Relationship

Message

Insurance Policy Holder Information

(The main person on the insurance policy)

Primary Insurer's Name*

First Name Last Name

Primary Insurer's Date of Birth*

Insurance Information

Insurance Provider*

Insurance Phone*

Insurance ID Number*

Insurance Group Number*

By submitting this form, I agree to receive communications, including texts, calls, and/or emails, regarding services, appointments, alumni resources, and news from Northpoint brands.

Request a call back!

Prefer us to call you to complete the insurance verification?

Enter your name and number and we’ll call you back shortly

Name(Required)

First Name Last Name

Phone(Required)

By submitting this form, I agree to receive communications, including texts, calls, and/or emails, regarding services, appointments, alumni resources, and news from Northpoint brands.

Prefer to verify your insurance over the phone?

Patient Information

Contact Information

Insurance Policy Holder Information

Insurance Information

Request a call back!

Our Omaha Location

Contact Us

Send a Message

Northpoint Omaha

888.687.8014

Northpoint Programs

Northpoint Locations

Inpatient

Outpatient

Imagine By Northpoint

Follow Us On