Insurance Information
Collect your clients' insurance details securely and easily. Clients can provide their insurance information and upload photos of their insurance card, all in a HIPAA-compliant form. This helps streamline verification, billing, and record-keeping, while keeping sensitive information private. Practitioners should have clients update this information annually to ensure accuracy.
Form Template Preview
Submit this form to see what a completed submission looks like inside Hushmail:
Quick facts about this form
Who it's for:
- Healthcare practices
- Behavioral health providers
- Physical therapy clinics
- Chiropractic practices
- Massage therapy practices
- Dental practices
- Nutrition professionals
- Holistic care providers
Why use it:
- Ensure HIPAA-compliant collection of sensitive insurance data
- Reduce admin time spent verifying insurance details
- Streamline billing and claims processing
- Allow clients to upload images of their insurance card for faster intake
Where to use it:
- Sent via email before the first session
- Completed during the client’s intake or registration workflow
- Sent annually to clients to verify and update insurance information
If your client skips a required field, the form will prompt them to fill it out. No more chasing after clients to fill out missing info.
Your client’s submission will live in Hushmail, where you can keep all submissions secure and organized in folders.
You can also download a PDF of the submission if you want to file a separate copy elsewhere, like your EHR.
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1.
You give us the form(s) you’re currently using in your practice.
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You get a dedicated Customer Care rep to oversee the service and answer questions.
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You end up with custom secure web forms that are easy for your clients to fill out.
