update your card on file You can submit a new card using our secure online system or you can give us a call and we would be happy to help! Online Portal Give us a Call Secure Online PortalUse our secure online portal to update your credit card information. Click the link below to continue! Click Here to Continue Sample image of the online portal we're here for you Simply fill out the form and we’ll be in touch soon. Call or Text Us Questions or not sure what next step to take? We're here for you! During our working hours you'll likely be able to connect with someone on our admin team immediately. CO: 303-902-3068 FL: 904-439-4400 Contact Us "*" indicates required fields First Name* First Name Last Name* Last Name Email* Phone*Select Preferred Location*Castle Rock, COCentennial, COColorado Springs, COLakewood, COSt Augustine, FLWestminster, COWheat Ridge, COOnlineI'm not sureState of Residence* What state do you live in?Hidden- Does the person seeking counseling have coverage under Medicaid or a Medicare Disability plan?* No Yes - Medicaid Yes - Medicare Disability Are you or the client(s) covered by Medicaid, CHP+ or a Medicare disability plan?NoYes - MedicaidYes - Medicare Disability* We do accept some Medicaid plans, but will need to verify benefits.Medicaid ID Number* Date Of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How can we help?*How would you like to be contacted?* Email Phone Text * You will also receive a confirmation text and email upon submitting this form. Are you a robot? 46847 Cornerstone accepts CCHA Medicaid but does not bill other insurances. We do provide superbills for potential reimbursement.