Patient Information

Urology Center

Expert Care in a Full-Service Urological Facility

The Urology Center, P.C. Logo

What to Bring to Your Appointment
Patient Forms
Fees and Insurance
NEW - Pay Your Bill Online
Your Responsibility
Advance Directive
Your Right to File a Complaint

What to Bring to Your Appointment

  • Your insurance card
  • Physician referral forms if required by insurance
  • A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
  • Pertinent information about your medical and surgical history
  • Any recent x-rays or appropriate records you may have

Patient Forms

We are pleased to offer you the opportunity to complete the forms on your computer (you can type directly onto the form), then PRINT THE COMPLETED FORMS and bring them with you to your appointment to help reduce your waiting time.

If you have any questions about these forms, please contact us at the practice directly.
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Fees and Insurance

Our fees are based on the service provided, time, tests involved, and the treatment required. The fees of our top procedures are available upon request. To keep our records current, please come prepared to show your insurance card/Medicare card each time you visit The Urology Center, P.C. We participate with the majority of area HMOs, PPOs, and other managed care plans. It is necessary to bring your referral with you if required by your insurance company. Co-payments are expected at the time of your visit. For surgery and other diagnostic procedures, payment arrangements may be made with our billing department. While the ultimate responsibility for the payment rests with you, the patient, we would be happy to file with your primary insurance carrier and most secondary insurances. You will receive a monthly statement whenever there is a balance due. We encourage you to call our billing department at 402.397.5255 with any questions you have on your account.

Pay your bill online

Click here to pay your bill online.

You Have the Responsibility

  • To keep your appointments.
  • To provide complete information about your past health.
  • To let us know if you do not understand or cannot follow our health care instructions.
  • To cooperate fully in the treatment program you and your doctor have agreed to.
  • To be prompt in payment of your account.
  • To provide all information necessary to qualify for any financial assistance you may request.
  • To provide information about current medications or treatment being rendered by other physicians.
  • To provide us with accurate demographic information including phone number, address, employer information and insurance information.

Advance Directive

Regardless of any advance directives set forth in a living will, health care power of attorney or other written statement, any unexpected medical emergency, in this facility, will be managed with resuscitative or other stabilizing measures followed by a transfer to a hospital's emergency department. If you have an executed advance directive, please bring a copy with you at the time of your appointment. We will place the directive in your medical records. If you need assistance in obtaining an advance directive form, please contact us for assistance.

Your Right to File a Complaint

If you believe your rights as a patient have been violated, you may file a complaint with our administrator. To file a complaint with our office, contact our administrator at:

The Urology Center, P.C.
Laura Forehead, Administrator
111 South 90th Street
Omaha, NE 68114

Additionally, you may inform the following governmental agencies of your complaint:

Michael Grutsch, PA-C
DHHS Division of Public Health Investigations
1033 O Street, Suite 500
Lincoln, NE 68508

Office of Medicare Beneficiary Ombudsman

Refer a Friend

Main Location
111 S. 90th Street
Omaha, NE 68114
Tel: 402.397.9800
Tel: 800.882.4770
Fax: 402.397.7591
Toll Free: 1.800.882.4770

Athena Health EHR for TUC Physicians
Peak Practice EHR for TUC Physicians

View our complete list of locations

Tel: 402.397.9800
Our main number is answered after hours by our answering service. They can assist you and contact a physician for you.