Request membership eligibility and benefits online.

  • Easily request membership eligibility and behavioral health insurance benefits online with the Membership and Benefit Request form. Know your client’s mental health insurance benefits before their appointments. When you submit the Membership and Benefit Request form, one of our membership service representatives will respond within 1 business day. You may also call Quest at 800-364-6352 to verify membership eligibility and benefits.

    * indicates a required field
  • Provider Information

  • Member Information