New Pediatric Patients

Thank you for choosing Children First Pediatrics as your child's medical home, where we always provide a comfortable, caring environment so our patients and their families can feel at ease. We've included helpful items on this page to ensure you and your child's first trip to our office is productive, stress-free and enjoyable.

Our Mission

Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence and value. To fulfill this mission, we are committed to:

  • Improving the lives of the children we serve by providing quality care in a child-centered environment.
  • Listening to our young patients and their families who we are privileged to serve.
  • Guiding our patients along a path of optimal health and wellness.
  • Continually pursuing excellence at all levels through continuing education.

If you're preparing for your child's first visit, you can do a few things to help expedite the appointment. Please provide the following information when you arrive for your visit:

  • Insurance cards
  • Complete immunization records
  • Medical records from your previous pediatrician

Patient Forms

Pre Registration is now offered prior to every office visit via your appointment text or email reminder through Phreesia.  This is our preferred and private method of obtaining your information and changes to your information.

We are also happy to provide our office forms for convenient download on your home computer. Please print and complete the forms below, and bring them with you to your child's first appointment. Questions about which forms you need? Please call our office and our courteous staff will assist you in preparing for your child's first visit.

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

The Initial Visit

Our compassionate city pediatricians do whatever it takes to make every visit to our office a pleasant, relaxed experience. With all of the important information about our practice available on our website, you can feel confident that you and child are well-prepared for your first appointment. We also invite you to review our staff page in order to get to know our doctors and staff. We look forward to meeting you.

Your Rights Under the No Surprises Act

When you get emergency care or are treated by an out-of-network provider at an in-network health care facility, such as a hospital, you are protected from surprise billing or balance billing. The No Surprises Act does not apply to individuals with coverage through programs such as Medicaid and the Children's Health Insurance Program (CHIP). The No Surprises Act does not apply to medical offices when there are other medical office options within the community that are in-network for your health plan.

What is "balance billing" or “surprise billing"?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan's network.

"Out-of-network" describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called "balance billing." This amount may be more than your in-network costs for the same service and might not count toward your annual out-of-pocket limit.

"Surprise billing" is an unexpected balance bill. This can happen when you can’t control who is involved in your care – such as when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

For what types of services am I protected from balance billing?

Emergency services-- Effective January 2022, if you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can't be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center--Effective January 2022, when you receive services from an in-network hospital or ambulatory surgical center, certain providers at that facility may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services.

Children First Pediatrics is providing this notice as a public service to our patients. We ask that you bring your insurance card to every office visit for verification of our participation in your insurance. If we do not accept your insurance we will let you know prior to your visit provided as long as you bring your current insurance information.  We will provide you with information on the estimated visit cost.  For non-emergent services in our office you will have the option either to see our provider out-of-network and file with your insurance on you own, or cancel your appointment and find another in network provider within the community who participates with your plan.  

You are not required to get care out-of-network. You can choose a provider or facility in your plan’s network. The Nebraska Out-Of-Network Emergency Medical Care Act applies only to emergency services. Therefore, as applicable, the billing of your care involving non-emergency services is governed by federal law such as the rights and protections involving nonemergency services.

If you believe you’ve been wrongly billed, you may contact the Department of Health and Human Services (HHS) at 1-800-985-3059. Visit https://www.cms.gov/nosurprises website for more information about your rights under federal law.

If you have insurance-related questions, please contact the Nebraska Department of Insurance at 402-471-2201 or call toll-free consumer hotline at 1-877-564-7323. Visit www.doi.nebraska.gov for more information about your rights under Nebraska law.