Patient Responsibilities

• New and Established Patients

  • All patients will be asked to sign the required authorization forms when coming to our clinic. You are required to bring your current insurance cards & photo id (for protection of your health information) to each appointment. It is very helpful for the providers if you bring a copy of your current medications to each appointment so they can be updated accordingly. If you are a new patient it is requested to have your previous provider send your records.

• Insurance & Billing

  • Pool Medical Clinic participates with many insurance programs including but not limited to BCBS, Midlands Choice, United Health Care, Aetna, Medicare, & Medicaid. Our office files claims to most insurance companies but ultimately you are responsible for settling your account. If you have any questions, please contact our Finance Department at 308-425-6221 opt. 3.

  • Personal Pay patients are expected to pay $213 at the time of their initial visit. After established care, patients will be expected to pay $150 each visit prior. If you require additional services during your visit you will be presented with an estimate of your cost and may be requested to pay a portion of the estimated cost. 

  • Workman's Compensation or Automobile insurance are accepted with a confirmed claim number and contact information for the assigned case worker. If you are seen for an accident of any kind without this information, your visit will remain personal pay until the correct information is received. 

• Tobacco Free Campus

  • Pool Medical Clinic is a Tobacco Free Campus. Medication is available to patients to curb their craving for tobacco. We also offer information on Tobacco Cessation.

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New & Established Patient Forms​