Privacy Policy

For your convenience, you may view and print a copy of Family Practice’s Notice of Privacy Practices (NPP) in either English or Spanish. Please see below.

You may also view and print a copy of the clinic’s Authorization to Disclose Protected Health Information (PHI) in either English or Spanish. Completion of this form is necessary before your medical records can be released.

Please call the clinic at 308-381-0162 if you have any questions.

Downloads:

New Patient Forms

If you are new to our clinic, please download and complete the three forms below and bring them with you to your appointment. To schedule an appointment, please call 308-381-0162.

Payment Policy

Payment is expected at the time services are provided, including insurance co-payments. If an additional amount is due, a statement will be mailed to you, due within 30 days. Charges and payments for services received during the last few days of the billing cycle may appear on the following month’s statement. When making on-line payments, please allow 3-5 business days for processing with the credit card company and posting to your account.

Medical Records

Medical records cannot be released without proper authorization. Should you need to have your medical records released, please complete the Authorization to Disclose Protected Health Information (PHI). We value the patient privacy act to ensure your privacy remains protected.

Insurance

Please bring all current health insurance cards to each appointment. If the insurance company requires a copayment, it is due upon check in prior to your appointment. As a courtesy, we will file all insurance claims, but we cannot accept responsibility for negotiating claims with insurance companies. We will file third party liability and motor vehicle claims upon request with appropriate information. If the insurance company fails to pay in a timely manner, it is the responsibility of the patient for prompt payment of all amounts due.

We are in network with:

  • Aetna (Coventry)
  • Blue Cross Blue Shield of Nebraska
  • Cigna
  • Medica
  • Medicare
  • Midland’s Choice
  • Nebraska Total Care (Centene) – not accepting new patients
  • Tricare
  • United HealthCare Community Plan
  • United Healthcare
  • WellCare of Nebraska

Family Practice will accept what insurance companies allow as full payment for covered services. The patient is responsible for payment of any deductible, copayment or coinsurance, as well as for all non-covered or denied services by the insurance company.

Non-Discrimination

Family Practice complies with section 1557 of the Affordable Care Act and applicable Federal Civil Right Laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Refill Policy

Our goal is to provide high quality health care for you and your family. Family Practice electronically refills and prescribes your medications through the electronic health record (EHR). This process allows for the most accurate monitoring of your medications.

In order to provide refills for our patients and reduce the risk of medication errors, Family Practice has established the following guidelines:

  • Refills are done Monday – Friday, 8am-4pm. We will not refill medications after hours (including weekends, evenings and holidays).
  • Please do not call the clinic for your refill request, contact your pharmacy to request refills.
  • Please allow two (2) business days for medications to be refilled.
  • If you are taking an opioid (narcotic) medication, you will receive additional information regarding the use of this medication, including informed consent and a patient-provider agreement in the clinic.

Appointments

Providers see patients by appointment only. Appointments can be made by calling our office, sending a request through the portal or in person at the clinic. Patients are asked to bring current identification, insurance card(s) and all medications.

If you are unable to keep your appointment, please call the office prior to your appointment so other patients may be scheduled. We make every effort to adhere to the appointment schedule, however, due to emergencies, this may not always be possible. To schedule an appointment, please call 308-381-0162.

Phone Calls

Many patients call the office with medical questions. When a call comes in, information is taken from the patient and relayed to the nurse. The nurse consults with the provider and then relays the provider instructions back to the patient. Phone calls are returned as quickly as possible, in the order they are received. Every possible attempt is made to return phone calls the same day.