B.E.S.T. Chiropractic Clinic / Dr. Yoshio Homma, D.C.
Please fill out the form below to verify your insurance coverage.
We accept most of health insurances.
First Examination and Treatments or Re-Examination and Treatments
$120 and up
$70 and up
• Fees may vary by treatments provided
● Each insurance plan has a different coverage and policy.
● Your health insurance may not cover for Chiropractic care.
● We do not accept Medi-Cal of California State.
This form is ONLY FOR CHIROPRACTIC
|Insurance Plan / Policy*|
Subscriber ID number
Medicare is generally for people over 65
|Relation to the subscriber*|
|Reason for treatment/examination/visit*|| |
|Which part of your body?*|| |
|Work Related Injury? (Workers Compensation)*|| |
If Yes, you must have a claim number from your manager/HR of your company before visiting our clinic.
|Auto Accident Injury?|| |
If Yes, your auto-insurance is primary insurance therefore, most likely we will claim it to the auto insurance
|Which language do you prefer to use?*|
We will call you to confirm your chiropractic coverage within 48 hours.