Billing & Insurance

In order to accommodate the needs and requests of our patients we have enrolled in numerous managed care insurance programs.

  • Blue Cross Blue Shield of Nebraska
  • Coventry
  • First Health
  • Choice Care/Humana
  • Midlands Choice Network Providers
  • United Healthcare
  • Medicare and Railroad Medicare
  • Medicare Advantage Plans (check with our Billing department for specific plan participation)
  • Medicaid Nebraska (all plans)

While we are pleased to be able to provide this service to you, it is extremely difficult for us to keep track of all the individual requirements of the plans.  Each one has different stipulations regarding how often services may be rendered and, even more importantly, where those services may be performed.

Even within the same insurance company, the plans differ depending upon what type of contract your employer has negotiated.

Providing quality medical care for our patients is our primary concern.  We are more than willing to provide that care within your insurance contract guidelines if you let us know at EACH time of service exactly what those guidelines are.

Unfortunately, if you do not inform us of any special requirement in your contract and we subsequently order services, such as lab work or hospitalization, that are not covered, we or the selected medical facility will have no choice but to bill you directly for those charges.  Payment for those charges is then your responsibility.

With your cooperation and help, you should be able to receive all of the benefits offered to you, and we will be able to concentrate on caring for your medical needs.

Additionally, we will collect a co-pay as indicated on your insurance card.  However, insurance policies vary and the possibility remains your insurance company may apply your charges to a deductible or require additional co-insurance to be paid by the patient.  We have no control over how your claim is processed by your insurance company and any issues related to processing of claims must be addressed with your insurance carrier.

Can I pay my bill online?

Yes, please click here to access the online bill page. You will need your CodeID, Access# and Account# found on your billing statement.

Will you file my insurance?
We will file your health insurance, provided we are given the correct and complete information. It is your responsibility to follow up with your insurance company after the claim has been filed. Remember the insurance coverage is a contract between you and your insurance company.
Will all services be covered by my insurance?
Your insurance policy defines the benefits of coverage you are entitled to under your policy. While each plan is different your plan may cover all or some of the cost of your treatment or services, less any deductible, and co-insurance amounts which are your responsibility. Your plan may not cover certain drugs, routine labs, or other services they deem as a non covered benefit. If questions, contact your insurance.
Why am I receiving two bills with the same account number?
Our billing department bills for both the physicians bill (Urology PC) and also the facility bill (Urology Surgical Center). You will receive separate bills when you have something done in our surgical center. You will also receive a bill from Associated Anesthesiologist PC if you have a procedure which anesthesia is necessary.
Why am I getting a bill from LabCorp?
There may be certain lab tests that are necessary in your treatment or care that we don’t perform in our lab and are sent out to LabCorp, or to Pathology Medical Services if a pathology test is required.
What is Co-Insurance?
This is the percentage amount the covered person must pay for covered services which is determined by your insurance company.
What is deductible?
This is the amount which the covered person must pay each calendar year for covered services BEFORE benefits are payable by the insurance company.
What is a copayment?
This is a fixed dollar amount for which your insurance company requires that you pay at the time the services are provided. Your co-pay is due prior to services and normally the specialist co-pay is applied at our office. Co-pays often are applied to office visits, but can be applied differently depending on your insurance contract.
Why can I not see my previous payment on my statement?
In the current computer program that we have if your balance is in an aging process and you are making monthly payments you can only see the balance forward, we realize this is inconvenient and are working on updating this in the near future. If you have questions, please feel free to call and verify that your payment has been received and credited to your account. We will be happy to assist you.
Why has Medicare denied my claim?

There are many reasons that can apply here, but remember neither Medicare nor other insurances pay for everything; there are exclusions to every plan. We will do our best to contact Medicare and try to help in that determination, please call our billing department for assistance.

Is there a charge for a No Show appointment?

Yes. As of 9-1-2010 there is a $25.00 fee if you do not show up for a scheduled appointment. We make every attempt to contact you at least 1 day in advance with a reminder call, so if you have a change of phone number it is important that you update our records so that you will receive this notification. This fee must be paid prior to rescheduling the appointment.

Why do they ask for copy of my insurance card each time I’m in your office?

This is done to best serve you and to be able to file the claims to the proper company. Many times, insurance companies change addresses, or the in network claims processor changes but not the actual insurance company-these changes are important to billing as the claim may go to a totally different place. If your employer changes plans from one year to the next, it is imperative that you provide us with the newest card thus why you are asked if your employer has changed, or if you have retired. Details on insurance cards are very important to correctly filing your claim.

 

What is an EOB (Explanation of Benefits)?

This is the paper that is mailed to you and also to us that helps explain how your claim was paid. It will tell us if you have deductible to pay, if there is a co-insurance amount due, or what your responsibility will be. You should get a copy of the same thing that is mailed to us. It will also explain if there is a contract adjustment ( an amount that we would write off if we have a contract with your insurance).

Will you notify my insurance if I have to have a surgical procedure at the surgery center or at the hospital?

Yes we will contact your insurance company and notify them of your surgery, this does NOT mean that we are checking your benefits. Knowing the benefits is your responsibility, your policy manual should tell what is or is not covered, please contact your insurance company to find out what your responsibility will be, we will provide you with the necessary codes to inquire with your insurance. If you specifically want to know what your out of pocket cost will be, our patient accounts manager will assist you with this process.

How much does a Vasectomy cost?

Our office policy requires the patient to come in for a consultation with the physician first, that is the initial fee involved. The vasectomy is performed in our outpatient surgical center so there are charges for both the physician and the outpatient facility. If you would like a fee quote please call 402-489-8888 opt 4. At the time of your consultation our patient accounts manager will provide you with a cost estimate of the surgery before it is scheduled. Since this is an elective procedure prepayment of the estimate is required.

Why does my statement say the account is delinquent when I’ve been making payments?

Our current system applies the preloaded messages regardless of your payments. If necessary, you must contact our office and make payment arrangements; otherwise payment is due 30 days from your statement date.

 

What does it cost for an office visit?

There are 15 different levels of visits depending on many factors, so determining this prior to your visit would be very difficult to do, so we do not quote office visits for that reason.