Verify Your Insurance Benefits

Let Newport help you understand your treatment coverage.

Insurance benefits for detoxification, substance-use treatment, behavioral health, outpatient services, and medication treatment vary by insurance plan. Complete the confidential form below and a member of Newport’s Admissions Team will review your information and contact you regarding your benefits and treatment options.

No insurance? You can still submit this form. Eligible uninsured individuals with addictive disease treatment needs may qualify for free detoxification or outpatient services at Newport.

Confidential Benefits Review

Insurance Verification Form

Complete the form below as accurately as possible. Newport’s Admissions Team will review the information you provide and contact you regarding available benefits and treatment options.

Patient Name:(Required)

First Last

Patient Date Of Birth:(Required)

Patient Phone:(Required)

Email Address:(Required)

Primary Insured State:(Required)

State

Insurance Company Name:(Required)

Member ID #:(Required)

No insurance? You may still qualify for free treatment.

Newport provides no-cost detoxification and outpatient addictive disease services to eligible uninsured individuals through available funded programs. Please submit your information and our Admissions Team will help determine your eligibility and available services.

Group # (if available):

Policyholder Name:

Policyholder Phone Number:

Policyholder Date of Birth (if different from the patient):

Relationship to Policy Holder:

Requested Service:(Required)

Upload the Front and Back of Your Insurance Card:

Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, webp, Max. file size: 512 MB, Max. files: 2.

Preferred Method of Contact:(Required)

Phone

Best Tome to Contact:(Required)

Questions Before You Submit?

Our admissions team can help.

If you have questions about treatment services, insurance verification, or next steps, contact Newport Integrated Behavioral Healthcare.

(404) 289-8223 Admissions & Referrals

Insurance Verification

Verify Your Insurance Benefits

Insurance Verification Form

Our admissions team can help.

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Insurance Verification

Verify Your Insurance Benefits

Insurance Verification Form

I do not have insurance

Our admissions team can help.

Quick Links

Useful Links

Make Appointment