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Provider Cultural Demographic Survey

Nebraska Total Care is committed to providing culturally competent care and services to all of our members. Culturally responsive care leads to health equity.

It is important that cultural demographic data such as race, ethnicity, cultural groups, and cultural specialties are collected from Providers so we may assess network adequacy for our members and give our members opportunities to achieve their best possible outcomes. This is not only best practice, but also a National Committee for Quality Assurance (NCQA) requirement as well. We need to be able to match members with Providers based on their cultural needs, and in order to do so, we need to begin to collect this data.    

The data will be shared with our member facing teams so they may assist members with finding a provider that meets their needs when applicable. In addition, the information will be included in our Find a Provider search tool. 

The Plan does not, in providing or administering health-related insurance or other health-related programs, discriminate on the basis of race, color, ethnicity, national origin, sex, gender, religion, gender identity, sexual orientation, age, marital status, or disability.

The Plan does not exclude people or treat them differently because of race, color, ethnicity, national origin, sex, gender, religion, gender identity, sexual orientation, age, marital status, or disability. Please access the survey below.

This survey is optional, but we hope you will participate by completing any questions you are comfortable with. Please ensure each individual practitioner and/or licensed staff at your organization has the opportunity to submit their specific data. It will be issued quarterly to ensure we capture data of as many providers as possible, but individual providers will only need to complete it once a year unless they would like to update their responses. 

If you have any questions, please email NetworkManagement@NebraskaTotalCare.com.

What is Culture?

Culture includes but is not limited to the languages we speak, our thoughts, how we talk with each other, relationships, actions, customs, beliefs, values, age, physical abilities or limits, traditions, gender identity, sexual orientation, where we live, and also racial, ethnic, religious or social groups.  And more!  We are all a combination of many different cultures!

Product Type (Select all that apply.)
Race and Ethnicity (Select all that apply.)
Primary language:
Secondary language:
Sex Assigned at Birth
Gender Identity (Select all that apply.)
Are you a Tribal member?
Are you a Military Veteran?
Are you a Military family member?

Thank you for taking the time to complete this survey!  If you have any comments, feedback, or concerns about the survey please email NetworkManagement@NebraskaTotalCare.com.