Billing & Patient Accounts

Q:  Why am I getting a statement for a payment I already made? 

A: Any payments made may take 2-3 weeks to post to the account. If you make your copayment at the time of service, it is normal to receive one statement while payment is being processed before posting to account. You may not see the payment you have made reflected on the next statement but it will show up once posted. 


Q: Why am I getting billed if I already paid at the time of my office visit?

A: Patients who are on the sliding fee discount program are asked to make their nominal fee payment (currently $30 - $70) at the time of their appointment for the office visit. Any lab work, x-rays, vaccinations, etc. will be charged after the visit is completed, because we don’t know those costs at the time of the visit. Patients will see these charges on their next statement. If you would rather pay for those charges on the day of your visit, please ask the front desk for an estimate of the charges. If the doctor has not completed their charting, charges may not be known until the encounter is closed.  


Q: How much does it cost to be seen as a self-pay patient if I have no insurance and have chosen not to apply or do not qualify for the sliding fee discount program?  

A: Patients should be prepared to pay $100.00 at the time of visit. Any remaining balance for office visit and other applicable charges will be billed on their next statement. If the patient does not have the $100 and has an emergent condition, they will be triaged by a Nurse, and they will be billed for their visit if the condition requires they be seen that day. If the condition is not urgent, the patient may be asked to reschedule their appointment for a later date.    

Q: Why didn’t my sliding fee discount program fee apply to my office visit?

A: Sliding fees discounts expire every 12 months. If your benefits expire, you need to reapply with our Patient Support Specialist. Patients are given 30 days to renew their sliding fee discount program application following their medical appointment or their account will be moved to the “Self-Pay” status. To ensure you are still eligible for the sliding fee discount program, please verify when you make your appointment.


Prescription Requests

Q: I need a refill on my prescription; what should I do?

A: All prescription refills need to be initiated by the Pharmacy. Please notify your Pharmacy 7 days before you run out of medications. Calling the doctor instead of calling the pharmacy requesting a refill will slow down the process.  


Q: My Pharmacy says that they have sent the refill request and they have not received a response from the Provider; what should I do?

A: All Pharmacies handle refill requests differently. Pharmacies request prescriptions refills by two common methods: electronically and by fax. Electronic refill requests go straight to the provider’s Electronic Health Records queue, which usually get faster responses. Requests submitted by fax have to be manually researched, depending on what other tasks the nurse is working on at that time, refill requests are filled on a first come, first served basis. We receive over 200 refill requests a day and have 4 Nurses monitoring these refill requests. Each time a Pharmacy sends a request, the more paperwork that accumulates on that nurse’s queue.


When the Nurse receives the fax, he/she has to look up the patient in the Electronic Health Record, send a refill request to the Provider and then the Provider has to electronically submit the refill request. Providers try to check their queues several times a day, but depending on how many patients they see that day, it is common for them to refill the medications 2 days after receiving the request. That is why we tell all of our patients to request the medication refill when they still have 7 days left.  


Q: I ran out of my medication and need some to get me through the weekend/week; what should I do?

A: Bluestem Health tells patients they should request medication refills through their Pharmacy 7 days before they run out. If you do not follow this process, we make no guarantees the medication refill will be filled within 2-3 days after the refill request is received from the Pharmacy. 


Phone Calls

Q: I tried to call my doctor to get a refill request and nobody has called me back.

A: All medication refill requests must be requested by the pharmacy. Patients who call the Provider’s nurse for a medication refill are given lower priority than patients who call with more urgent needs.


Q: I called to schedule an appointment but I was not able to get through to someone.

A: In 2017, Bluestem Health went to a dedicated scheduling desk which is manned by two team members. While we cannot guarantee how long you may have to be on hold, our internal phone system audits show that the average hold time is 3 minutes.


Q: I called and left a message for my Provider, but nobody has called me back.

A: Your message did not go to your Provider; it went to the Provider’s nurse. The  nurse must return phone calls when they are not busy rooming and engaging with their patients. We ask that our nurses check their message twice a day, if possible, before lunch and around 3:00pm. Anyone leaving a message after 3:00pm should not expect a call back until the next business day.


Q: I’ve called my doctor’s nurse many times and get no answer.

A: We are currently installing a system to document phone calls that are received by patients, so we can verify patient phone call requests. If you have not received a call back 4 hours after your first phone call, please feel free to call back to the main number and ask to speak with the clinic manager.  


Q: I got lab work done and nobody called me back.

A: For most patients, if the lab work comes back with no issues, they will not receive a phone call back. If lab work comes back and it needs to be addressed by the Provider, the Provider or their nurse will call you back to discuss the lab works and talk about future remedies. Sometimes, it takes 1 or 2 days for the lab company to get results back to us. If the lab company notices an abnormal or dangerous lab, they will call the on-call Provider to notify them and the patient will be notified, if warranted.



Q: I’ve been sitting in the waiting room for 15 minutes past my appointment; why does this happen?

A: All of our Providers want their schedules to run on time. The further they get behind, the longer they and their staff have to stay after normal work hours to finish their paperwork and cleaning the rooms. There are various reasons why a Provider may be late. Sometimes, the patient(s) before you took longer because of procedures, an emergency, or the patient had a complex issue that required more attention. Please anticipate your appointment taking 60 minutes from check-in; it may not take that long, but at least you’ll have allowed for that amount of time.  


Q: Why did I lose my appointment because I was late?

A: Patients get upset when their Provider is not on time. Patients who come late push back the entire patient schedule. So, to help the Provider from falling way behind on their schedule, we have the right to reschedule patients who are late for their appointment.


Q: My appointment was given to someone else; why did that happen?

A: Bluestem Health makes every attempt to remind patients of their upcoming appointment. Currently, 1 out of 4 patients does not show up for their appointment. Our EHR allows us to call, text, or email patients a reminder for their appointment. If you are asked to confirm your appointment and do not, we assume that you no longer want that appointment. Please be sure to confirm you appointment when we contact you.


Q: My Provider wouldn’t refill my pain medication; why not?

A: Pain management is the most common reason why patients complain. In recent years, there has been a big push for Providers to prescribe less opiate medications because of the amount of abuse in the system. Providers base their prescriptions for pain management off of many different values. Ultimately, it is their medical license on the line if they over prescribe narcotic medication and a patient has a bad reaction to it. Therefore, each Provider deals with pain management in a way that they feel comfortable with prescribing.  


Q: Why won’t you prescribe me an antibiotic over the phone?

A: Antibiotic treatments are taken seriously because of the resistant forms of diseases out there that are caused from the over utilization of antibiotics. The Provider wants to make sure you have all of the signs and symptoms of a bacterial infection, to which antibiotic prescriptions may be appropriate. Patients with a virus are usually not candidates for antibiotics and the virus must run its course. However, many over-the-counter medications can be used to help treat the symptoms of viral infections.


Dental Clinic

Q: If I do not have insurance or Medicaid how much do I have to pay for the initial dental visit?

A: Your first appointment will be with our Patient Support Specialist who will review your sliding fee application and documents with you. Depending on your sliding fee discount, the initial visit fee varies. We usually tell our patients to bring the nominal fee of $75.00 for a comprehensive oral exam and full mouth series of radiographs. 


Q: Can I come in for an emergency walk in/call in visit for a tooth ache, and, if so, what will it cost me?

A: We will try to work with our schedule to accommodate an emergency walk in/call in patient to the best of our ability within a day or two. We charge our fee based on the sliding fee discount with the nominal fee being $36.00 for a limited oral exam and one x-ray. If the patient needs a tooth taken out during that visit, then the cost of simple tooth extraction would be $65.00 which brings the total to $101.00. 


Q: Can I become a new patient and have my teeth cleaned in the same visit?

A: No. Your first visit will be with a dentist, who will go over your health history; the dental assistant then takes a full mouth series of x-rays. The dentist will do a thorough oral exam; they will review your x-rays and develop a treatment plan. Depending on your oral health, the dentist may suggest different types of cleaning (simple/deep cleaning or gross debridement). 


Appointments for cleanings will be scheduled with a dental hygienist. During the cleaning, the dental hygienist cleans the patient’s teeth and educates you on ways to improve and maintain good oral health while teaching appropriate brushing and flossing techniques.


Q: Why must I get a full series of x-rays to be a patient at your clinic?

A: A full mouth series is a complete set of intraoral X-rays taken of the patient’s teeth and adjacent hard tissue. These X-rays are used to check for decay between the teeth. They also show bone loss when severe gum disease or a dental infection is present. They help to find dental problems in the jaw, such as impacted teeth, abscesses, cysts, tumors, and bone changes linked to some diseases. They help the dentist do a thorough oral evaluation. 


Q: Why do I have to wait for 2-3 months to have my teeth worked on once I have my exam?

A: Since we are one of the two safety-net dental clinics in Lincoln and offer sliding fee discount, we do get a lot of patients from Lincoln and surrounding areas needing dental care. Our schedules fill up quickly.  We do our best to accommodate each patient that walks through our door, but we do have a no-show list, so feel free to call us occasionally to see if we have cancellations or a no-show which might allow you to get an appointment. 


Q: I have pain in my wisdom teeth. Can I get them taken out?

A: Extraction of wisdom teeth can be complicated. We do extract simple erupted wisdom teeth at our clinic. We can definitely do a limited exam; try to take an x-ray but most of the time these patients require Panorex (x-rays of the upper and lower jaw). We do not have a Panorex machine at our clinic, so those patients are referred to the College of Dentistry or Oral Surgeons in the community for extraction of impacted wisdom teeth.