Verification of Benefits
To verify coverage for a policyholder you can:

• Call our provider assistance line at 1-402-398-0881,
• Send a fax to 1-402-398-0895, or
• Email us at pa@gomedico.com.

Be sure to include the policy number and the name of the policyholder.

For those providing care, the following forms are available:

Facility Certification of Care
This is a form for those who are moving from one facility to another or who are going into a facility for the first time. Staff from the facility need to fill out this form.

Monthly Verification of Continuing Care
This is a monthly form to be filled out by facility staff and mailed in with billing each month. This form is used if the person has been in care for 30 or more days.