RegLab

Billing Forms

Advanced Beneficiary Notice (ABN)

ABN Form (English)
ABN Form (Spanish)
ABN instructions
Prior Authorization
Prior Authorization Form

Patient Consents

Patient Consent for Non-Covered Laboratory Services Form

Patient Consent for Non-Covered Laboratory Services Form (Spanish)

Financial Assistance

Financial Assistance Application

 
 
24/7 Client Services
800-334-0459

Main Office
Regional Pathology Services
University of Nebraska Medical Center
Department of Pathology, Microbiology and Immunology
981180 Nebraska Medical Center
Omaha, NE 68198-1180

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