Patient Info – Triangle Kidney Associates

New Patients

Patient info

Acknowledgement of receipt of Notice of privacy practices

Service coverage & payment agreement

Medical release form

HIPAA form for Privacy Practices

Physician Practices

Patient Referral form

Insurances Accepted

BCBS NC Commercial Plans

Bcbs Blue Medicare
Blue Advantage
Blue Care
Blue Options
Blue Select
Classic Blue
North Carolina State Health Plan
WellCare
Carolina Complete Care Health
NC Medicare
NC Medicaid
Railroad Medicare
GHI PPO
Medcost PPO /Medcost Preferred
Multiplan / Phcs
Inclusive Health
American Health
Principal Life Insurance

RMSCO Inc
USAA Life Insurance Company
Todays Option PFFS
Meritain Health
MVP Health Care
Physician Mutual
PAI
TUFTS Health Plan
Conn General Life Ins Company
Geha
Advantra Freedom
AIG Travel Guard
Americas 1st Choice
Dept of Veterans Administration
Gunderson Lutheran Health Plan
Mutual of Omaha
Pyramid Claims

Tricare Plans

Tricare Standard
Tricare Prime
Tricare Prime Remote
Tricare ppo

Tricare HMO
Tricare for Life
Tricare North/East

United Health Plans

Golden Rule
Oxford
AARP
River Valley
Umr
All Savers
Wellmed
Secure Horizon
Choice HMO, Choice Plus HMO
Unicare
University Health Alliance
One Net PPO
Choice Plus Harvard Pilgrim
Care Improvement Plus
Allied National
AIG Claims Inc
UHC Community Plan

Sedgwick CMS
Pinnacol Assurance
Choice with Harvard Pilgrim
Charter / Charter Balanced
Charter HMO
Compass / Compass Balanced
Compass HMO / Compassed Balanced HMO / Compass Plus HMO
Compass Plus
Core Plan
Core Essential care
Core HMO / Core Essential HMO
Select Plus
Medica Choice with UnitedHealthcare Choice Plus
Select HMO
Heritage Select POS/HMO
Options PPO with Harvard Pilgrim

Uhc Medicare 2018 Plans

AARP MedicareComplete (HMO)
AARP MedicareComplete Essential (HMO)
UnitedHealthcare Assisted Living Plan (HMO-POS SNP)
UnitedHealthcare Dual Complete (HMO SNP)
UnitedHealthcare Dual Complete RP (Regional PPO SNP)

UnitedHealthcare Group Medicare Advantage (HMO)
UnitedHealthcare Group Medicare Advantage (PPO)
UnitedHealthcare Nursing Home Plan (HMO SNP)

Humana Plans

Humana ChoicePOS
Humana/ChoiceCare Network PPO
Humana/ChoiceCare+ Network PPO
National POS – OpenAccess
National POS – OpenAccess Plus
Humana GoldChoice Ntwk PFFS

Medicare PPO
Medicare PPO/Employer PPO Plus
EPO PPO Open Access
Gold Plus HMO Raleigh
GE Health Care Preferred
COT National POS – OpenAccess

Alignment Health Care Plans

FIRST MEDICARE DIRECT PREFERRED PLUS HMO
FIRST MEDICARE DIRECT SMART HMO (005)
FIRST MEDICARE DIRECT SMART HMO/HMO (005)

HUMANA GOLD PLUS H1036 233-HMO
HUMANA GOLD PLUS H1036 233-HMO

Cigna Plans

Cigna Greatwest
HMO/Network – CIGNA HealthCare of North Carolina, Inc. HMO/Network
Cigna OAP Network
HMO/Network – CIGNA HealthCare of North Carolina NET-NET POS Seamless
PPO, Choice Fund PPO

Open Access Plus, OA Plus, ChoiceFund OA Plus with CareLink
Open Access Plus, OA Plus, ChoiceFund OA Plus
Cigna Connect plan
CIGNA APWU PLAN

Coventry Plans

Carelink – Traditional
CoventryOne POS
Advantra Gold (PPO)
Coventry one National Network
First Health Network
Aetna Choice POS II
Coventry (HMO or POS)
Coventry Preferred (PPO)
CoventryOne
Assurant Health

Advantra Gold
Carelink – Traditional
Carolinas HealthCare System Tier 2
Carelink – CaroMont Tier 2
Carelink – Duke Medicine Tier 2
Carelink – Midlands Tier 2
Carelink – Regional HealthPlus Tier 2
Carelink – Roper St. Francis Tier 2
Carelink – Cornerstone Tier 2
Carelink – Upstate Tier 2

Aetna Plans

Aetna Essentials Plan(PPO)/Essentials PPO
Aetna Medicare Basic Plan (HMO)/HMO Basic
Aetna Medicare Basic Plan (HMO)/OA HMO Basic
Aetna Medicare Basic Plan (HMO)/Open Access Basic HMO
Aetna Medicare Basic Plan (HMO)/Referral Req Basic HMO
Aetna Medicare Choice Plan (HMO)/HMO Choice
Aetna Medicare Choice Plan (HMO)/Referral Req Choice HMO
Aetna Medicare Choice Plan (PPO)/Choice PPO
Aetna Medicare Choice Plan (PPO)/Choice Plan PPO
Aetna Medicare Connect Plus (HMO)/HMO Connect Plus
Aetna Medicare Connect Plus (HMO)/Referral Req Connect Plus HMO
Aetna Medicare Connect Plus (HMO)
Aetna Medicare Connect Plus (PPO)/Connect Plus PPO
Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
Aetna Medicare Elite Plan (HMO)/HMO Elite
Aetna Medicare Elite Plan (HMO)/OA HMO Elite
Aetna Medicare Elite Plan (HMO)/Open Access Elite HMO
Aetna Medicare Elite Plan (HMO)/Referral Req Elite HMO
Aetna Medicare Elite Plan (PPO)/Elite PPO
Aetna Medicare Essential Plan (PPO)/Essential PPO
Aetna Medicare Essential Plan (PPO)/Medicare Essential PPO
Aetna Medicare Essential Plan (PPO)/PPO Essential Plan
Aetna Medicare Freedom Plan (PPO)/Freedom PPO
Aetna Medicare Gold Plan (PPO)/Gold PPO
Aetna Medicare Innovation Choice Plan (PPO)/Innovation Choice PPO
Aetna Medicare Innovation Choice Plan (PPO)/PPO Innovation Choice Plan
Aetna Medicare OH Connect Gold (Regional PPO)/Connect Gold RPPO
Aetna Medicare OH Connect Gold (Regional PPO)/OH Connect Gold RPPO
Aetna Medicare OH Connect Gold 2 (Regional PPO)/Connect Gold 2 RPPO
Aetna Medicare Platinum Plan (HMO)/Referral Req Platinum HMO
Aetna Medicare Platinum Plan (PPO)/Platinum PPO
Aetna Medicare Plus Plan (PPO)/Plus PPO
Aetna Medicare Premier Plan (HMO)/HMO Premier

Aetna Medicare Premier Plan (HMO)/OA HMO Premier
Aetna Medicare Premier Plan (HMO)/Open Access Premier HMO
Aetna Medicare Premier Plan (HMO)/Referral Req Premier HMO
Aetna Medicare Premier Plan (HMO)
Aetna Medicare Premier Plan (PPO)/PPO Premier Plan
Aetna Medicare Premier Plan (PPO)/Premier PPO
Aetna Medicare Premier Plus (PPO)/Premier Plus PPO
Aetna Medicare Select Plan (HMO)/HMO Select
Aetna Medicare Select Plan (HMO)/OA HMO Select
Aetna Medicare Select Plan (HMO)/Open Access Select HMO
Aetna Medicare Select Plan (HMO)/Referral Req Select HMO
Aetna Medicare Select Plan (HMO)/Select HMO
Aetna Medicare Select Plan (HMO)
Aetna Medicare Select Plan (PPO)/Select PPO
Aetna Medicare Select Plan (PPO)/Select Plan PPO
Aetna Medicare Standard Plan (HMO)/HMO Stnd
Aetna Medicare Standard Plan (HMO)/OA HMO Stnd
Aetna Medicare Standard Plan (HMO)/Open Access Standard HMO
Aetna Medicare Standard Plan (HMO)/Referral Req Standard HMO
Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
Aetna Medicare Standard Plan (PPO)/Standard PPO
Aetna Medicare Syracuse Plan (PPO)/Syracuse PPO
Aetna Medicare Value Plan (HMO)/HMO Value
Aetna Medicare Value Plan (HMO)/OA HMO Value
Aetna Medicare Value Plan (HMO)/Open Access Value HMO
Aetna Medicare Value Plan (HMO)/Referral Req Value HMO
Aetna Medicare Value Plan (HMO)
Aetna Medicare Value Plan (PPO)/PPO Value Plan
Aetna Medicare Value Plan (PPO)/Value PPO
Aetna Medicare(SM) Plan (HMO)
Aetna Medicare(SM) Plan (PPO)
Aetna Premier Plan (PPO)/Premier PPO

Aetna 2017 plans

Aetna Medicare℠ Plan (HMO)
Aetna Medicare Value Plan (PPO)/Value PPO
Aetna Medicare Premier Plan (PPO)/Premier PPOChange

Aetna Medicare Value Plan (HMO)/Referral Req Value HMO
Aetna Medicare℠ Plan (PPO)

Aetna Leap 2017 plans

Aetna Leap CHS Health Network Only Open Access
Aetna Leap Cape Fear Valley Health
Aetna Leap CaroMont Health
Aetna Leap Carolinas HealthCare System

Aetna Leap Cornerstone Wake Forest Baptist
Aetna Leap Duke Health
Aetna Leap North Carolina Open Access HMO
Aetna Leap South Carolina Open Access HMO

Aetna 2018 plans

Aetna Medicare Premier Care Network
Aetna DC Bronze,silver & Gold Open Acess Health Network only
Aetna DC Bronze,silver & Gold Open Acess Health Network only
Aetna DC Silver & Gold ppo

Aetna MD Bronze,silver & Gold Open Acess Health Network only
Aetna Premier care network Plus
Aetna Premier care network