Provider Information & Forms

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Lifespan Health
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What would you like to do?

What you need to know

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​​​​​Do you have patients losing or changing insurance coverage?

Insurance changes shouldn't stop PREVENTIVE care!

If you have women in your practice who are losing or dropping insurance coverage, remember Every Woman Matters (EWM) may be able to assist with well-woman visits.  For eligible clients, EWM offers:

  • Breast and cervical cancer screenings for women 25-64
  • Colon cancer testing for women and men 45-74

Early prevention saves lives!

Your patients can Enroll Now or call 1-800-532-2227 to see if they qualify! ​


Thank you for providing health care services for Women's and Men's Health Programs, which includes Every Woman Matters and the Nebraska Colon Cancer Screening Program.  Screening and early cancer detection is an important step in helping Nebraskans live longer, healthier lives.

Already a provider and want some in person or online training? 
If you are interested in finding out more about program training for your clinic (to review processes, procedures, and policies), please contact us!​  

​Are you considering becoming an enrolled health care provider?
 
Click on the "I Want to be a Provider" tab below to find more information and specific enrollment forms. 

If you have specific questions regarding Every Woman Matters or the Nebraska Colon Cancer Screening Program, please call 1-800-532-2227.​​

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Contracted Pro​vider (doctors and clinic) Listing

Contracted Provider Listing (visual map where you select the type of service:
Well-Woman Visit, Mammography, or Colonoscopy) and search for providers near you.​


Medicaid Expansion Information

Heritage Health Adult expands Medicaid to lower income adults (age 19 to 64) who earn up to 138% of the federal poverty level. For more information or to see if your patients are eligible please visit the Medicaid Expansion site. 

Medicaid Expansion Toolkit: Heritage Health Adult (HHA) Resource Toolkit​

Diagnostic Enrollment/Follow-Up and Treatment Forms

Diagnostic Presumptive Eligibility Checklist
Diagnostic Reference Quick Guide​

Breast Diagnostic Enrollment/Follow-Up Treatment
  English
  Spanish
  Breast Diagnostic Instructions

Cervical Diagnostic Enrollment/Follow-Up Treatment
  English
  Spanish
  Cervical Diagnostic Instructions

WANT TO LEARN MORE?:

Breast Diagnostic Enrollment Lesson​ - Everything you need to know about breast diagnostic enrollment in EWM
Cervical Diagnostic Enrollment Lesson​ - Everything you need to know about cervical diagnostic enrollment in EWM​​​​

Presumptive Enrollment

All contracted Women's and Men's Health (WMHP) provider sites can offer PRESUMPTIVE ENROLLMENT for preventive screening services. If a patient comes in for services and they are eligible for Every Woman Matters (EWM) or the Nebraska Colon Cancer Screening Program (NCP), you, as a clinic, can enroll them that day and provide services the same day.  Clinics will be responsible for determining client eligibility.

Reduce barriers for your patients!  Currently, if a patient is eligible, they fill out the Healthy Lifestyle Questionnaire (HLQ), program staff review it, and a Screening Card is mailed to the client within 2-3 weeks.  Get your patients screened sooner! 

Clinics MUST be trained and approved as a Presumptive Enrollment Provider

STEPS TO PROVIDE PRESUMPTIVE ENROLLMENT FOR YOUR CLIENTS:  

  • STEP 1: COMPLETE a Training
    Contact us for an in-person or virtual training with your clinic team.

OR

AND

Presumptive Enrollment-Healthy Lifestyle Questionnaire  (English)
Presumptive Enrollment-Healthy Lifestyle Questionnaire (Spanish)
Quitline Fax Referral​

WANT TO LEARN MORE? 
Presumptive Enrollment Lesson - Everything you need to know about enrolling a client and providing services to the client on the same day of enrollment. ​

Claim and Payment Status Forms and Policy

Timely Submission of Claims and Documentation Policy
Claims for services provided during a previous Fiscal Year (July 1- June 30) must be received by EWM/NCP with primary Explanation of Benefits and documentation by December 31st following the end of the Fiscal Year. Claims received after the filing deadline will be entered into the EWM/NCP Billing System and denied for Timely Filing. Claims denied for Timely Filing may not be billed to the client(s).

Claim Status Form
Payment Status Form​​

Healthy Behavior Support Services

Every Woman Matters offers free or reduced cost Healthy Behavior Support Services to help clients reach their weight, fitness, and nutrition goals.  Healthy Behavior Support Services may include the following:

Health Coaching - Connect with a health coach that will help support your goals for a healthy lifestyle.  Explore additional resources and supports available in your community and virtually!  Health coaching can be done virtually or by phone.  3 sessions scheduled to match your needs and availability.  More information can be found in the Health Coaching Flyer.

Health Coaches for Hypertension Program - Program for individuals with high blood pressure or at risk for developing high blood pressure.  Topics include blood pressure tracking, nutrition, physical activity, stress management, tobacco cessation, and medication management. Virtual or may be available in your community in-person.  

National Diabetes Prevention Program - In person or virtual program for people who have prediabetes or are at risk of Type 2 diabetes, but who do not already have diabetes.  16 weekly sessions and monthly follow-up sessions. Topics include healthy eating, physical activity, stress management and goal setting.  

Living Well - For people with diverse medical diagnoses such as diabetes, arthritis, and hypertension develop skills and coping strategies to manage their symptoms.  Virtual or in-person workshops in some communities. 

Walk & Talk Toolkit
- Small group program may be available in your community!  10 weeks of “walk and talk" sessions covering topics to help you live a healthier life.   

Tobacco Cessation - Ready to quit tobacco?  1-800-QUIT-NOW (784-8669).  Free Quitline services are available 24/7 in over 200 languages.  Web-based coaching is also available.  Encouragements throughout your quit journey.​ More information can be found by going to the Tobacco Free Nebraska website.

Program Specific Webinars, Newsletters, Training and Resources

Screening Enrollment Lesson - Everything you need to know about qualifying factors and enrollment in the Every Woman Matters and Nebraska Colon Cancer Screening Programs

Screening Card Lesson​ - What to do with the Screening Cards patients bring to their appointments

Breast Diagnostic Enrollment Lesson - Everything you need to know about breast diagnostic enrollment in EWM

Cervical Diagnostic Enrollment Lesson​ - Everything you need to know about cervical diagnostic enrollment in EWM​

Colon Cancer Program Lesson​​ - Everything you need to know about the Nebraska Colon Cancer Screening Program

Other Important Forms​​ - How to use other forms and resources from EWM

Referring EWM Clients to Nebraska Tobacco Quitline​ - How to refer your Every Woman Matters patients to the Nebraska Tobacco Quitline


Women's & Men's Health Quick Reads Newsletter - Provider Updates, Highlights & Prevention Insights:

2026: 
  Issue 14-October 2026​ || Issue 13-September 2026​ || Issue 12-August 2026​ || Issue 11-July 2026​ || 
  Issue 10-May/June 2026 || Issue 9-April 2026​ || ​Issue 8-March 2026 || Issue 7-February 2026 || 
  Issue 6-January 2026
2025: 
  Issue 5-September 2025​ || Issue 4-July 2025 || Issue 3-April 2025 
  Issue 2-February 2025
2024: 
  Issue 1-October 2024  ​

Trainings and Continuing Education Resources
The Health Resources and Services Administration (HRSA) and the Federal Cervical Cancer Collaborative (FCCC) released a new resource, Improving Patient Engagement in Cervical Cancer Prevention: Communication Toolkit for Health Centers and Safety-net Settings of Care​.  The Patient Engagement Toolkit supports to increase patient and community engagement in cervical cancer prevention, screening, and management.  Materials include social media posts, posters, a cervical screening follow-up card and more.  Toolkit/Materials are available in English and Spanish.

Hospital & Healthcare Guide 2019

Health Equity and Prevention Primer - web-based training series for public health practitioners and advocates interested in achieving health, safety and health equity through policy advocacy, community change, and multi-sector engagement.

CANCERcare.org - dedicated to providing free, professional support services including counseling, support groups, educational workshops, publications and financial assistance. 

PeerView Institute - dedicated to improving clinical competence and performance, patient outcomes and ultimately public health through the provision of continuing education (CME and professional development activities.  Credits are available FREE of charge for physicians and nurses.  Many classifications of topics are available.

American Academy of CME, Inc. - recognizes the importance of continuing education for professional development for healthcare professionals and the need to address clinical practice gaps that impact patient care.  The Academy provides certified continuing education to physicians, nurses, nurse practitioners, physician assistants, pharmacists, dieticians, social workers/case managers, transplant coordinators and other healthcare professionals.

Agency for Healthcare Research and Quality - clinical practice guidelines and resources are housed on this site.​

Nebraska Tobacco Quitline Adds Continuing Education Opportunity for Healthcare Providers:  Accredited courses are now available online, through the Nebraska Tobacco Quitline, for providers looking to receive CME, CNE, or CPE credits.  To access tools, resources, and education modules, plus the web and fax referrals for providers ready to help patients quit, go to: QuitNow.ne.gov/providers  ​

Professional and Public Cancer Education and Informational Resources

Please Note:  T​hese resources are intended to provide information and are not necessarily endorsed by the Women's and Men's Health Program. Links to non-Federal organizations in this document are provided solely as a courtesy to providers. These links do not constitute endorsement of these organizations or their programs by EWM or the Federal government, and none should be inferred.  EWM is not responsible for the content of the individual organizations' web pages found at these links.​

​
Patient Advocate Foundation
|| Hampton, VA || (800)532-5274
https://www.patientadvocate.org​

Specializes in mediation, negotiation and education, on behalf of clients experiencing the following issues:    Preauthorization, Debt Crisis, Access to Pharmaceutical Agents, Access to Chemotherapy, Access to Medical Devices, Access to Surgical Procedures, Expedited applications for Social Security Disability, Medicare, Medicaid, SCHIPS, etc. Provides professional case managers who negotiate with insurers to resolve coverage and benefit issues, patient employers to mediate job discrimination issues and client creditors to facilitate resolution of debt crisis matters.  They utilize the AT&T Language Line that enables the case managers to assist clients in 140 languages. Assists uninsured, underinsured, as well as Medicaid and Medicare recipients to resolve coverage and benefit issues.

CULTURAL COMPETENCY AND LANGUAGE ACCESS RESOURCES

  • Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards)
    https://thinkculturalhealth.hhs.gov/clas 
    In March 2001, the U.S. Department of Health & Human Services Office of Minority Health completed a final report of the 14 CLAS standards.  Standards provide goals and guidelines so that healthcare providers can ensure that they are providing the best quality care with the goal of eliminating the health disparities that exist across racial and cultural lines.  Culturally Competent Care (Standards 1-3); Language Access Services (Standards 4-7); Organizational Support for Cultural Competence (Standards 8-14). Standards 1-3, and 8-13 are Guidelines; Standards 4-7 are Federal Office of Civil Rights 1964 Requirements; and Standard 14 is a Recommendation.
  • Language Services Associates || Willow Grove, PA || (800)305-9673
    https://www.lsa.inc​
    Provides services 24/7 365 days a year in 180 languages.  Other services include: quick connections, 
    multiple party conferences, language identification assistance, on-site or via phone.
  • ​Language Line Services - Certified Medical Interpretation Services || Monterey, CA || (800)752-6096
    https://www.languageline.com
    Provides services 24/7, 365 days a year in over 150 languages.  Other services include: Quick Connections, Multiple Party Conferences, Language Identification Assistance, On site or via phone, Specialize in Health Care Arena.
  • Nebraska Association for Translators & Interpreters (NATI)
    http://www.natihq.org       
    Serves as a resource and a forum on interaction for language service providers and those who utilize their services.

BREAST AND CERVICAL CANCER RESOURCES: 

American Cancer Society (ACS)
(800)ACS-2345 or (800) 227-2345  (Spanish language services available)
P.O. Box 24168 || Omaha, NE  68124 || 800-227-2345
https://www.cancer.org/
A nationwide, community-based, voluntary health organization dedicated to eliminating cancer as a
major health problem by preventing cancer, saving lives and diminishing suffering from cancer, through research, education, advocacy and service.  Information and some services are available to clients and their families, healthcare providers and the general public.  In addition, loans of breast prosthesis and wigs may be available through your local American Cancer Society Office.  (Educational Brochures Available)

  • ​Patient Services Center - American Cancer Society
    (888)227-2345 - Case managers assist clients to find resources and financial services.

Look Good Feel Better Foundation
(800) 395-5665
Free virtual and in person workshops designed to help cancer clients cope with changes in appearance due to cancer treatment.  These programs are free-of-charge and include a make-up kit courtesy of the Personal Care Products Council, Cosmetics, Toiletries & Fragrance Association.

American Society for Colposcopy and Cervical Pathology (ASCCP)
301-857-7877
https://www.asccp.org/
Provides American Society for Colposcopy and Cervical Pathology (ASCCP) Algorithms from the Consensus Guidelines for the Management of Women with Cervical Cytological Abnormalities and Consensus Guidelines on the Management of Women with Histological Abnormalities.  Among other services, ASCCP also provides practice recommendations and continuing medical education. 

​Association of Cancer Online Resources
https://www.smartpatients.com/site/partners/acor
Provides links to pertinent resources for all types of cancer.

​AVON Foundation
https://www.avonworldwide.com/supporting-women/avon-foundation-for-women
Provides resources for a wide range of breast cancer programs and services, educational outreach and referrals for medically underserved women, as well as information and services regarding domestic violence and emergency relief.  Provides an on-line support group.

​Breast Cancer.Org
https://www.breastcancer.org/
Provides women diagnosed with breast cancer a comprehensive site that includes information on
everything from diagnosis to treatment and beyond.  Has a “chat room" to respond to concerns
immediately for women who need support from someone who has been there already.

​Cancer Care, Inc.
(800) 813-4673  (Spanish language services available)
https://www.cancercare.org/
Provides free, professional support services for anyone affected by cancer.  Free one hour
teleconferences for cancer clients, their families, and healthcare providers working with people with
cancer.  People can participate from the office or home to learn more about issues as they relate to cancer.

Cancer Center Helpline, Omaha, Nebraska
(402)559-9999  or  (800)999-5465 (Spanish language services available)
www.nebraskamed.com/cancer/support-services
Free telephone information service provided by Nebraska Medical Center. Educational information and resources for healthcare providers and public available from oncology nurses.

Cancer Support Community
(272)867-5307 || https://www.cancersupportcommunity.org/
Support group for people with cancer.

​Cancer Survivors Network
https://csn.cancer.org/
Discussion boards for peer support. Sponsored by the American Cancer Society and deals with survival issues, long term effects of treatment and general support.

​Healthfinder
https://odphp.health.gov/myhealthfinder
An award winning Federal Website for consumers, providing on-line publications, clearinghouses, databases, websites, support and self-help groups, as well as government agencies and not-for-profit organizations that produce reliable information to the public.

Heartland Cancer Foundation                      
(402)261-9974 || P.O. Box 5203 || Lincoln, NE 68505
https://www.heartlandcancerfoundation.org/
Removes barriers to care by providing housing and transportation grants for local cancer patients in need of additional support during treatment.

Krames Patient Education / WebMD Ignite 
(800) 333-3032 || 800 Township Line Road || Yardley, PA  94066-3030
https://kramesstore.com/
One-stop-shop for client education materials in a variety of print and electronic formats available for purchase.

Livestrong Foundation
https://livestrong.org/
Lance Armstrong's web site that provides information and encouragement to all cancer clients in partnership with Patient Advocate foundation.

​MammaCare Corporation
(352) 375-0607 || 930 Northwest 8th Avenue || Gainesville, FL  32601
http://www.mammacare.org/
Provides breast models, clinical breast exam and breast self-exam interactive training systems for both public and professional education. Includes adaptive learning systems for visually and hearing impaired clients. Certified clinical breast examiner training courses are also offered.

​Medicare Helpline
(800)MEDICARE || https://www.medicare.gov/                  
Medicare Rights Helpline
(800)633-4227 - say the word “Agent" to speak with someone                                  
Consumer Questions Regarding Medicare

​Medline Plus
https://www.medlineplus.gov/
A service of U.S. National Library of Medicine and the National Institutes of Health. Site contains information on more than 650 health topics, drug information, a medical encyclopedia, and dictionary, as well as directories, current news and interactive tutorials.  (Select articles available in 40 different languages, downloadable in PDF format.)

Medscape
https://www.medscape.com
Offers patient and professional information, free professional education including CME's and CEU's for healthcare providers, conference coverage, and discussion boards.

​National Breast Cancer Coalition
(202)296-7477 or (800)622-2838 || https://www.stopbreastcancer.org/
A national advocacy group that lobbies for increased research funding, access to medical services, and education.  Also provides “Guide to Breast Cancer Care" online, which is based on 6 core elements of values: access, information, choice, respect, accountability, and improvement.

National Cancer Institute -- Cancer Information Service (NCI -- CIS)
(800)4-CANCER  or  (800)422-6237  (Spanish language services available) || https://www.cancer.gov/​
Supported by the National Cancer Institute to provide accurate and up-to-date information on cancer to clients and their families, healthcare providers and the general public.

Nebraska Cancer Research Center
(402)483-2827 or (800)487-8786 || Lincoln, Nebraska
Focuses on clinical trials, provides a wig bank and referrals to community resources.

​Cancer Nation
(301)650-9127 or (877)622-7937 (Spanish language services available)
https://canceradvocacy.org
Provides information about survivorship and sources of support for cancer survivors and their families. Their mission is to advocate for quality cancer care for all people touched by cancer.

​National Comprehensive Cancer Network
(215)690-0300 || https://www.nccn.org/
NCCN is an alliance of 34 of the world's leading cancer centers, working together to develop treatment guidelines for most cancers, and dedicated to research that improves the quality, effectiveness and efficiency of cancer care.  Clinical practice guidelines for healthcare providers and cancer treatment and supportive care guidelines for clients and their families are found on this website.

​National Lymphedema Network
(800)541-3259 || https://lymphnet.org
Provides complete information for clients, healthcare providers and the general public on prevention and treatment of lymphedema.

​National Women's Health Information Center
https://www.womenshealth.gov/
Gateway for women's health resources and materials for consumers and professionals.  Maintained by the U.S. Dept. of Health & Human Services.

Office of Health Disparities & Health Equity
(531)893-1649 || https://dhhs.ne.gov/Pages/Health-Disparities.aspx
The Office of Health Disparities and Health Equity (OHDHE) works to equalize health outcomes and eliminate health disparities in Nebraska and works with local and regional health agencies, other state agencies, faith-based organizations, and community-based organizations, to develop minority health training materials, and assist and support minority grantees and organizations working on minority health activities.

​Oncolink
https://www.oncolink.org/cancer-treatment
Comprehensive Cancer resource maintained by the University of Pennsylvania Cancer Center.  Many links to medical information, psychosocial support, discussion lists, journals and cancer news.

The Nebraska Medical Center
(800)922-0000 || Omaha, NE || https://www.nebraskamed.com/treatments
Information on types, diagnosis and treatment of different cancers.  Very informative for both healthcare providers and clients.

​Physician Data Query (PDQ)
(800)422-6237 || https://www.cancer.gov/publications/pdq/information-summaries
National Cancer Institutes comprehensive database - contains peer-reviewed summaries on cancer screening, prevention, genetics, treatment, supportive care, and cancer clinical trials from around the world.

Project Pink'd Inc.
(402)905-0691 || 12165 Pacific Street || Omaha, NE 68154 || https://projectpinkd.org/
Serves women in Nebraska and Iowa to help ease the financial burden for underserved survivors who are actively going through treatment. They provide services to survivors from point of diagnosis to end of life.

Susan G. Komen Breast Cancer Foundation
(877)GO-KOMEN - (877)465-6636 (toll free); (402)251-5355 (Omaha)
(212)712-8027 (for men with breast cancer) (Spanish language services available)
https://www.komen.org/community/nebraska
Dedicated to advancing research, education, screening and treatment of breast cancer (Educational Brochures Available)

​Young Survival Coalition
(877)972-1011 || https://youngsurvival.org/
An international non-profit for breast cancer survivors and supporters with a focus on women under 40.  The Young Survival Coalition's (YSC) educational programs are designed to reach not only our core audience of young women affected by breast cancer but also members of the medical community, friends, family members, caregivers, the breast health community, healthy young women and the general public.


CARDIOVASCULAR AND DIABETES RESOURCES:​

WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation)
https://www.cdc.gov/wisewoman

Heart Disease and Stroke:

Diabetes:

Free or Low-Cost Medication Access:

  • 340B Drug Pricing Program & Pharmacy Affairs - Health Resources and Services Administration (HRSA) requires drug manufacturers to provide outpatient drugs to eligible health care organizations/covered entities at significantly reduced prices. These entities include Federally Qualified Health Centers (FQHCs), Critical Access Hospitals, Local Health Departments, and more.  Check the link for a full list of eligible organizations/covered entities.  https://www.hrsa.gov/opa/index.html
  • Federal Trade Commission (FTC) - FTC provides useful consumer information regarding prescription    savings programs and generic drugs.
    https://www.consumer.ftc.gov/articles/0063-generic-drugs-and-low-cost-prescriptions
  • Medicare Information - Information about the specific drug plans available in a particular area and about Medicare drug plans in general are available at 1-800-MEDICARE (1-800-633-4227)
    https://www.medicare.gov
  • NeedyMeds - NeedyMeds keeps up-to-date information from pharmaceutical companies on patient assistance programs. (800)503-6897 https://www.needymeds.org/​
  • Partnership for Prescription Assistance - Helps you access public or private programs most likely to meet your needs. The Partnership for Prescription Assistance offers a single point of access to more than 475 public and private patient assistance programs, including more than 150 programs offered by pharmaceutical companies.  Eligibility requirements vary from program to program.  Contact the Partnership for Prescription Assistance toll-free at 1-888-331-1002 or at https://www.pparx.org      
  • Retail Prescription Program - Many retail outlets such as Bakers, CVS, Hy-Vee, Rite-Aid, Target, Wal-Mart, and Walgreens offer low- cost medication options. Many discount and retail stores offer prescriptions as low as $4.00 for a 30-day supply. The local pharmacy or local health department may also make low-cost medication available.
  • RxAssist - Funded by The Robert Wood Johnson Foundation, RxAssist is a web based medication resource center for providers, advocates, consumers, and caregivers. https://www.rxassist.org/providers
  • RxHelper - Our mission is to increase awareness of patient assistance and boost enrollment of those who are eligible through a variety of prescription assistance programs. (877)767-3297 || https://www.therxhelper.com    
  • Rx Hope - RxHope contracts directly with pharmaceutical companies to provide an electronic application process for their patient assistance programs. RxHope provides this service to physicians and patients free of charge. https://www.rxhope.com/
  • Rx Outreach - A nonprofit charity that provides critical medicine for people who can't afford it.  Offers more than 500 medications through mail order pharmacy delivered to all 50 states. With support of generous donors, Rx Outreach helps more than 85,000 people each year get the medications they need to stay healthy. (800)769-3880 || https://rxoutreach.org/

Tobacco Cessation:


I want to be a provider

In order to participate as a provider, a 6-page Provider Participation Enrollment Form is required.  Information about the Women's and Men's Health programs are included in the Women's and Men's Health Provider Participation Manual. Please call the office at (800) 532-2227 for more information.

Provider Enrollment Coverle​tter​
Provider Participation Enrollment Form
W9/ACH Form

Women's and Men's Health Provider Participation Manual (2026-2027 - UPDATED: October 1, 2026) ​

Women's and Men's Health Fee Schedule (2026-2027 - EFFECTIVE:  July 1, 2026)​

Provider One Pager - How do you know if a client is eligible?​ 

I want to schedule a training for our clinic!

Training for clinics is offered via zoom or in person, depending upon location.  If you are interested in finding out more about program training for your clinic (to review processes, procedures, and policies), please contact us!