Check Your Insurance Fill out the form and click 'Send'. We support NYSHIP, Aetna, UHC, Cigna and more — and we’ll verify your benefits for you. You will receive a call within 24 hours. Your information is being sent securely straight to us.Your information is being sent securely straight to us. Patient's Full Name Email Date of Birth Phone Number Primary Cardholder's Name (if different) Primary Cardholder's Date of Birth (if different) Address Insurance Carrier Insurance ID Number Insurance Customer Service Number Chief Concern Patient's Full Name Email Date of Birth Phone Number Primary Cardholder's Name (if different) Primary Cardholder's Date of Birth (if different) Address Insurance Carrier Insurance ID Number Insurance Customer Service Number Chief Concern