Attach photos of both front and back
Enter your name as shown on your insurance card.
Enter the insurance carrier name as shown on your insurance card.
Enter your member ID as shown on your insurance card.
Enter your Group ID as shown on your insurance card.
In order for Virta to provide the best quality of care and ensure we are updating member information correctly, we check to verify legal name and date of birth match our records, and collection date of the lab tests. We ask that you complete these fields to ensure security of your information.
The collection date is the date the blood was drawn at the lab facility
Please add any additional details about your request that may help us resolve it more quickly- screenshots are always helpful!