Insurance Forms
It is Children’s Bone & Spine Surgery’s policy to provide medically appropriate treatment at all times, regardless of race, color, national origin, religion, gender, age, marital status, personal appearance, sexual orientation, immigration status, or disability of the patient or the patient’s parent(s) or guardian(s).
At Children’s Bone and Spine Surgery, we strive to provide optimal care for our patient’s physical, mental and social health and well-being; for all of our infants, children, adolescents and young adults.
Anthem BCBS Coordination of Benefits
Culinary Accident Inquiry (English & Spanish)
Culinary Subrogation Form (English)
Culinary Subrogation Form (Spanish)
Tricare Subrogation Insurance
Tricare Subrogation Accident
Health Plans
Including but not limited to the following:
- Aetna Managed Choice POS: Referral required through Availity
- Aetna HMO: Referral required through Availity
- Aetna Select EPO: Referral required through Availity
- Anthem Medicaid
- Ambetter
- BCBS
- Cigna
- Construction Laborers
- Culinary
- Electrical Workers
- GEHA
- Health Net Federal Services (Tricare) Prime: Requires referral authorization
- Healthscope
- Hometown Health
- HPN Medicaid: Referral required
- Humana
- Nevada Medicaid
- Operating Engineers
- Oxford
- Plumbers and Pipefitters
- Sierra Products (PPO/POS only)
- Silver Summit Medicaid
- UMR
- United Health Care
- Molina Medicaid