(402) 758-5240

Patient Info

iStock_000034274066MediumOffice Services

Payment for office services is expected at the time of each visit to our office if you do not have insurance. An itemization of your charges will be given to you each time you are seen in our office. MasterCard, Visa, and Discover cards are accepted, as well as HSA account cards.

If you have insurance coverage, we will file your claim for you for your visit to our office.

We cannot look to a third party (i.e., auto insurance, liability) for payment of services rendered; therefore, the patient receiving such service is responsible. Any patient who wishes to discuss fees is encouraged to do so with our insurance billing department.

Our insurance department can be reached directly at (402) 758-5240 and we will assist you in any way possible. If you have any questions regarding a claim that has been filed, please contact the insurance department.

 

New Patient Registration Forms

Please print and then complete the documents below and bring it with you to your first appointment.  Completing the form prior to your arrival will help expedite your check-in.

Patient Registration

Medical History Sheet

HIPAA Acknowledgement Form

 

Medicare

We participate with Medicare and we will file your claims with them and with one supplemental carrier for all services rendered.  Medicare does not cover home infusion therapy, but it does cover in-office infusion therapy.

 

Health Plans

If your coverage is with one of the HMO’s and PPO’s with which we participate, we will file your insurance claim. Any co-payment amount must be paid at the time you are seen. Please bring any required referral forms with you or you will be responsible for your charges that day. A statement will be sent for any balance due, and your prompt payment will be appreciated.

Even though patients have insurance and benefits are payable, the insurance contract is between the patient and the insurance company; therefore, the prompt payment of our fees remains the personal responsibility of the patient.

If you are unable to pay your account in full on receipt of your statement, we ask that regular monthly payments of at least $50.00 or 10% of the balance commence following receipt of the first statement. Accounts are considered delinquent 60 days following the date of service.