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Insurance coverage verification
Please note, just because we (Body Balance Rolfing and Massage) are checking to verify coverage there is no guarantee that you have coverage for our services, and deductible and copayments will apply.  Additionally, it can take about a week (sometimes longer) to get the information, so please don't expect immediate answers.  Preauthorization or preapproval may be required.  Some insurance companies require a prescription.  Thank you.

Jenny is in-network with Blue Cross Blue Shield, Providence, MODA, and the VA Community Partners Network.  If you have United Healthcare, Cigna, Pacific Source,  Aetna, Kaiser, GEHA, or OHP, we do NOT accept your insurance, so please do not fill out this form.  Jenny can treat anyone with insurance from a motor vehicle accident or workers compensation claim.  

It is UNLIKELY that your health insurance will cover your care at 100%.   Most health insurance will only cover 60 minutes, and Rolfing sessions are 90 minutes.  This means that you will be responsible for the additional time (currently $130) plus whatever co-pay or co-insurance you have (typically $30 - $80).  If you have a deductible, that will typically need to be met before any of your coverage kicks in.  

All information is kept confidential and is ONLY used to verify coverage.  We will NEVER share or sell ANY of your information, including email and phone.    (2025)
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Email *
Name of person seeking treatment - first and last name: *
Name on record with insurance company, not a nickname.
Your phone number *
Birthdate of person seeking treatment *
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Type of Insurance *
Insurance company.  If it's not listed, we can't bill it. *
Required
Insurance ID Number (member ID for health, claim # for MVA or WC) *
  • For HEALTH insurance this will be a policy or customer ID number. For AUTO and WORKMAN'S COMPENSATION insurance, this will be a claim number.   For VA, it will be your SSN, so you don't need to list it here. We ALSO need the date of the accident here for auto or work comp claims.
Insurance company phone number(s)  *
Your relationship to the insured: *
Required
LEGAL name of Insured ONLY if DIFFERENT FROM PATIENT
Name on record with insurance company, not a nickname.
Insured's date of birth ONLY IF DIFFERENT FROM PATIENT
MM
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DD
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YYYY
General diagnosis *
Please be specific as the insurance companies need details. (Headaches, low back pain, scoliosis, etc.)
I understand that my insurance may not cover any of my session.   I further understand that Body Balance is billing my insurance as a courtesy and I am 100% responsible for full payment.   (Type your name as proof of your understanding and agreement.)
 *
Is there anything else you need to ask or tell us?
For more detail, we can talk/text (503-890-9365) or email,  jenny@BodyBalancePortland.com.
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