Fertile Crescent PediatricsFertile Crescent Pediatrics

 

Downloadable Forms

Patient Demo (PDF)

Authorization for Disclosure of Health Information (PDF)

Consent to Treat Form (PDF)

Financial Responsibility (PDF)

HIPAA PRIVACY POLICY (PDF)

Informed Consent for Circumcision (PDF)

NOTICE OF PRIVACY PRACTICES (PDF)

Patient Demo (PDF)

 

 

Insurance Plans Accepted

Blue Cross Blue Shield   Verity Healthnet
     
United Healthcare   USA Managed Care Organization
     
Aetna   Synergy Health Network
     
Coventry   Multiplan
     
American Lifecare   Focus Healthcare Management
     
Med-Comp, USA   First Health / CCN
     
Cigna   BCE Emergis
     
Office of Group Benefits   Evolutions Healthcare
     
PPO Plus   PPONext
     
FARA   ChoiceCare
     
GEHA / PPOUSA   Tricare Standard
     
Three Rivers   Universal
     
Best Care   Medical Resource Mgmt.
     
Universal    

 
 
Copyright 2009 Fertile Crescent Pediatrics