Insurance Verification Form

Please enter your primary insurance policy information below and we will digitally verify your out-of-network coverage for you. Please note that verification of benefits is not a guarantee of coverage or reimbursement.

Fill out all applicable questions on this form. Not all may apply to your specific insurance plan.

Insurance Verification

Policy Holder Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Member Date of Birth

Phone

Insurance Company Name

Payor ID

Member ID

Group ID

Preferred Contact Method(Required)

Phone

Text

Texting Consent
By submitting this form and signing up for texts, you consent to receive informational text messages (e.g., appointment notifications) from Thrive Medical at the number provided. Consent is not a condition of purchase. Msg & data rates may apply. Msg frequency varies. Unsubscribe anytime by replying STOP. Reply HELP for help. Privacy and Terms

Yes, I would like to opt in to receive text messages from Thrive Medical for offers and news.

Yes, I would like to opt in to receive text messages from Thrive Medical for customer updates

Accessibility Adjustments

Accessibility Commitment for Thrive Health of LI

At Thrive Health of LI, we are committed to making our digital presence as accessible and inclusive as reasonably possible for all users, including individuals with disabilities. Our goal is to improve the usability of www.thrivehealthli.com and to support a more accessible experience for everyone, regardless of their abilities or the technologies they use.

Our Approach to Accessibility

We aim to align with the Web Content Accessibility Guidelines (WCAG), which define internationally recognized standards for digital accessibility. While full compliance cannot always be guaranteed, we strive to implement improvements where feasible and regularly review accessibility-related aspects of our website. Accessibility is an ongoing process, and we are committed to improving the experience over time as technologies, standards, and user needs evolve.

Accessibility Features

To support accessibility, www.thrivehealthli.com may utilize tools such as the OneTap accessibility toolbar. This interface provides users with a range of helpful features, including:

Adjustable text size and contrast settings
Highlighting of links and text for better visibility
Full keyboard navigation of the toolbar interface
Quick launch via keyboard shortcut: Alt + . (Windows) or ⌘ + . (Mac)

Please note the following:

The availability and effectiveness of these features depend on the website's configuration and ongoing maintenance.
While we strive to ensure accessibility, we cannot guarantee that every part of www.thrivehealthli.com will be fully accessible at all times. Some content may be provided by third parties or affected by technical constraints beyond our immediate control.

Feedback and Contact

We welcome your feedback. If you experience any accessibility barriers or have suggestions for improvement, please contact us: Email: [email protected] We are committed to reviewing all inquiries and aim to respond within 3–5 business days. If you require assistance accessing any part of this website, we are happy to provide support through alternative channels upon request. Last updated: August 10, 2025

Select your accessibility profile

Vision Impaired Mode

Enhances website's visuals

Seizure Safe Profile

Clear flashes & reduces color

ADHD Friendly Mode

Focused browsing, distraction-free

Blindness Mode

Reduces distractions, improves focus

Epilepsy Safe Mode

Dims colors and stops blinking

Content Modules

Font Size

Default

Line Height

Default

Color Modules

Orientation Modules

Insurance Verification Form