Office Procedures
Online Bill Pay
For your convenience you can now pay your bill online!
Forms
Please complete and sign the forms and either fax to 402.489.5220 or print and bring the completed forms with you to our office along with a photo id and health insurance card.
Disclosure Authorization
Notice of Privacy Rights and Practices
Financial Policy
Health History
Patient Information
Physician Consultation Form
Participating Insurance Plans
ASC (Federal Work Comp)
Medicare
Medicare Railroad
Nebraska Medicaid
BCBS of Nebraska
PPO
Classic
Medicare Advantage
Coventry/First Health
ChoiceCare
Corvel
Interplan/Accountable
Midlands Choice
MultiPlan, Inc.
Mutual of Omaha
Private Health Care Systems
PPOUSA/GEHA
Tricare
United Health Care
