If you are an existing patient of Danielle, please use this form to give us all of the information we need to verify your benefits and submit claims. This website and emails are encrypted for security. Please pay special attention to the insurance issues listed at the end- insurance is a complicated, tricky business (they set the rules, we try our best to follow them!). If insurance cannot be sorted out at least 3 business days before the appointment, we charge the $80 full rate, and then refund any overcharge once the insurance pays (about 3-4 weeks after the appointment).
The office is not in network: Medicare, Medicaid, Magellan, Holman, HMC/APS/UFCW, United/ Optum, or AZ Foundation. We will only be taking Blue Cross until 10/31/2020.
Special insurance instructions
If a Banner employee, mental health usually goes through Cigna, not Aetna (like the medical part), so please fill in the Cigna Behavioral Health (it's a separate ID and insurance phone #).
Blue Cross out of state plans may not cover nurse practitioners like Danielle. Please call and make sure they will pay NP claims.
Compsych requires that you call and obtain a certification number for eval and follow-up visits.
Value Options/ Beacon requires a separate ID from your medical insurance- you must call and obtain this from them, or they will not pay.
MHN is a third party payer (different from your medical insurance) and requires a separate ID number from your medical benefit. They will not speak with us unless you provide us with the number.
Please click submit. We will attempt to contact your insurance to verify benefits, then we will send a message through the onpatient portal, letting you know what we find out. Thanks!
Your information will be encrypted.
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