Clinic Patient Billing Inquiry - CHI Health, Nebraska (NE) - Southwest Iowa (IA)
You may inquire about your CHI Health Clinic bill by completing the form below. For billing questions related to other CHI Health locations, please check your billing statement for an appropriate contact.

Please be aware that the information you provide here cannot be guaranteed to be confidential on the Internet. If you do not wish to transmit the information included in the following form electronically, please telephone the Customer Service Center at one of the following numbers:
Omaha Area: (402) 717-4300
Toll-free: (855) 515-9372
Fax: (402) 717-4321

NOTICE OF PRIVACY PRACTICES
The CHI Health Notice of Privacy Practices may be accessed at this link.
In order to complete your request, you must acknowledge receipt of this notice in the form below.
Acknowledge Receipt: No Yes

* required info
Name *
Email Address
Street Address
Apartment or Suite No.
City
State
Zip
Home Phone *
Work Phone
Account Number
Insurance Co. Name
Insurance Co. Address
Insurance policy No.
Insurance group No.
Copay amount
Your message or question: *