Verify Your Insurance

Verify Your Insurance

Shadow Mountain Recovery works with many insurance carriers and is an in-network provider with Presbyterian Health Plan of New Mexico and Colorado

SMR is an out-of-network provider for:

  • Aetna
  • BlueCross Blue Shield
  • Cigna
  • United Behavioral Health
  • Magellan Health Services
  • First Health
  • Value Options
  • MHNet Behavioral Health
  • Select Health

*We Accept many carriers not listed above

Complete the form below to verify your insurance:

Todays Date * (mm/dd/yyyy)

Your Name *

Your Phone Number

Your Email *

Relationship To Client: *

Referred By

Client's Full Name *

DOB: (mm/dd/yyyy) *

Age

Gender
 Male Female

Client's Address

City

State

Zip

Insurance Company *

Policy Holder *

Policy Holder DOB (mm/dd/yyyy) *

Employer

Group Number

ID#

Phone # To Ins Co

Best Time Of Day To Be Contacted

Notes