{"id":1325,"date":"2023-06-02T01:06:29","date_gmt":"2023-06-02T01:06:29","guid":{"rendered":"https:\/\/cimamd.com\/?page_id=1325"},"modified":"2023-06-02T01:09:03","modified_gmt":"2023-06-02T01:09:03","slug":"test-insurance-information","status":"publish","type":"page","link":"https:\/\/cimamd.com\/zh\/test-insurance-information\/","title":{"rendered":"TEST Insurance Information"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1328-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1328\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/zh\/wp-json\/wp\/v2\/pages\/1325#wpcf7-f1328-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/zh\/wp-json\/wp\/v2\/pages\/1325#wpcf7-f1328-o1\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1328\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.2\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1328-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p><label> Please specify your issues seeking for help.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"issues\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"issues\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> First Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Family Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"family-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"family-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> \u7535\u5b50\u90ae\u4ef6<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n<\/p>\n<p><label> \u51fa\u751f\u65e5\u671f<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-of-birth\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-of-birth\" \/><\/span> <\/label>\n<\/p>\n<p><label> Name of primary insurer if not self<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"primary-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"primary-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Date of Birth of primary insurer<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dob-primary\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"dob-primary\" \/><\/span> <\/label>\n<\/p>\n<p><label> Relationship with primary insurer<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"primary-relationship\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"primary-relationship\" \/><\/span> <\/label>\n<\/p>\n<p><label> ID#<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"id-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"id-number\" \/><\/span> <\/label>\n<\/p>\n<p><label> Group #\u200b\u200b<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"group-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"group-number\" \/><\/span> <\/label>\n<\/p>\n<p><label> Plan Name if applicable<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"plan-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"plan-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Deductible<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"deductible\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"deductible\" \/><\/span> <\/label>\n<\/p>\n<p><label> Copay information if applicable<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"copay\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"copay\" \/><\/span> <\/label>\n<\/p>\n<p><label> For Tricare DBN<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tricare-dbn\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tricare-dbn\" \/><\/span> <\/label>\n<\/p>\n<p><label> Insurance Card Picture Front (jpg or pdf 1mb or less)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"insurance-card-front\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpg,.jpeg,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"insurance-card-front\" \/><\/span> <\/label>\n<\/p>\n<p><label> Insurance Card Picture Back (jpg or pdf 1mb or less)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"insurance-card-back\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpg,.jpeg,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"insurance-card-back\" \/><\/span> <\/label>\n<\/p>\n<p><label> Driver's License Front (jpg or pdf 1mb or less)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"license-front\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpg,.jpeg,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"license-front\" \/><\/span> <\/label>\n<\/p>\n<p><label> Driver's License Back (jpg or pdf 1mb or less)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"license-back\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpg,.jpeg,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"license-back\" \/><\/span> <\/label>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"\u63d0\u4ea4\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"zh\"\/><\/form>\n<\/div>\n<\/div><\/div><\/div><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Please specify your issues seeking for help. First Name Family Name Email Date of Birth Name of primary insurer if not self Date of Birth of primary insurer Relationship with primary insurer ID# Group #\u200b\u200b Plan Name if applicable Deductible Copay information if applicable For Tricare DBN Insurance Card Picture Front (jpg or pdf 1mb&hellip;<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1325","page","type-page","status-publish","hentry","description-off"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>TEST Insurance Information - Dr Ci Ma<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cimamd.com\/zh\/test-insurance-information\/\" \/>\n<meta property=\"og:locale\" content=\"zh_CN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"TEST Insurance Information - 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