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Insurance Information
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Member ID :
Plan Name : CHOICE PLUS
Plan Type : Commercial
Copay (in-network) : $0.00
Co-insurance (in-network) : 0%
Active On 12/12/2024
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Your insurance manual verification request has been sent to your care manager. It will take some time, we'll let you know when it is completed. Meanwhile, you can continue to complete your appointment scheduling process.
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Appointment Confirmation
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Appointment Billing Summary
Total cost estimate:
This is estimated before you actually have the service and have health expenses under your insurance coverage. Generally, your total cost is your deductible + out-of-pocket cost + any copayments/coinsurance. Here is an estimate based on your plan, you’ll see on estimate of your total costs, but your actual expenses may vary.
Your responsibility estimate (In-network):
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Uploading Photo Instructions
Please take photo of your card like it is shown in the examples below
Use landscape orientation and ensure your card is clearly readable
Identifying ID Instructions
Front Side
Back Side
1. Your Identifying Information
Your health insurance card usually has your name on it. If you have insurance through someone else, such as a parent, you might see that person’s name on the card instead. The card might also include other information, such as your home address, but this depends on the insurance company.
2. Policy Number
Insurance cards will have a policy number, usually on the front of the card. Each health insurance policy has an associated policy number. On your card, it is often marked “Policy ID” or “Policy #.” The insurance company uses this number to keep track of your medical bills.
3. Group Plan Number
If you have health insurance through employer, your insurance card probably has a group plan number. The insurance company uses this number to identify your employer’s health insurance.
Out of Network
Out-of-Network Provider Notice
This provider is currently out of your network. You can proceed to schedule with them or select a different in-network provider.
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Appointment Confirmation
Payment Responsibility Acknowledgment
By proceeding with this appointment, you acknowledge that you will be responsible for the payment, including any applicable co-pay or self-pay amount.