HOXIE MEDICAL CLINIC

Healthcare from the Heart

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826 18th street, Suite A

Hoxie, Ks 67740-4373

Phone: (785) 675-3018

Fax: (785) 675-2306

 Walk-ins: M-F 7-08:30am Appointments: M-F 10-5pm

Our Mission

Hoxie Medical Clinic strengthens our community by improving health and wellness through the delivery of quality & compassionate healthcare, providing access to all.

Our Vision

To be a model health system by providing extraordinary care and superior service to each individual at an affordable cost.

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Hoxie Medical Clinic received a 330 Grant from the Health Resources and Services Administration (HRSA) in May of 2015 and became Northwest Kansas’ only Federally Qualified Health Center (FQHC). As an FQHC, we provide services to all patients regardless of insurance, financial status, or ability to pay. We offer a Sliding Fee for those who have a financial need based solely on family size and income. Hoxie Medical Clinic serves 13 counties in Northwest Kansas.  We accept Medicare, Medicaid, and most private insurance plans.

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NOTICE TO PATIENTS

This practice serves all patients regardless of inability to pay.  Discounts for essential services are offered depending upon family size and income.  You may apply for a discount at the front desk.  This practice accepts Medicare, Medicaid, and other insurance plans.

How it works…

Hoxie Medical Clinic offers a Sliding Fee Scale Discount to all eligible uninsured or under-insures patients. This program allows qualifying patients to receive medical care at a lower cost. Eligibility for the Sliding Fee Scale will be established by determining the household size and the annual household income. This info must be updated annually. HMC requires valid proof of income, household size, & completion of a Household Assessment when applying for the sliding scale fee discount.
If a patient chooses not to provide the required information, then he/she will not receive the discounted rate offered through the Sliding Fee Scale Discount Program.

If the patient declares no income, the patient must provide a collaborative letter from the individual assisting the patient financially (who is helping pay your bills, provide housing, etc).

  • Those who qualify for the sliding scale discount are expected to pay at the time of service. Refusal to pay the appropriate fee may result in the appointment being rescheduled. (some exceptions apply)
  • Patients with insurance coverage are also eligible to apply for the sliding fee scale. After the insurance has processed the claim & the patient has a remaining balance, then the balance may be adjusted based on the SFS.
  • Patients who don’t bring proof of income will be allowed to self-declare for the visit. Patient will need to supply income information 14 calendar days from date of service to qualify for Sliding Fee Scale. If completed application & proof of income is not received by the end of the 14 calendar days grace period he/she will be charged the full standard fee.

    The necessary documents are listed below. You may drop the completed forms off at the Receptionist’s desk.

    (Hyperlink Documents coming soon sorry for the delay. However they can still be picked up in person by asking the business office.)

 

  1. Federal Poverty Level Guidelines
  2. Interested Party Sliding Fee Letter
  3. Sliding Fee Application

Sponsored Care Application Process

A completed application including the required documentation must be on file and approved by the business office before a discount will be granted.   Those requiring assistance with the applicaiton process may contact Susan in the Social Services office at 785-675-3281 ext. 133.
Download the Sponsored Care Application

Other Downloadable Forms

Save yourself time when you come in for your appointment by filling out the appropriate forms and bringing them with you.

Health History Form
KAN Be Healthy Form
Current Medication List Form
School Physical Form

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Services Provided

Primary Medical care      Inpatient Services               Outpatient Services

                    Long-Term Care               Dental Health                      Addiction Counseling Referrals

             Case Management           Adult Immunizations         Behavioral Health Referrals

                   Well Child Exams            Child Immunizations         Certified Marketplace Navigator

           Well Woman Exams            STD Screening                 Sliding-Scale Fee Discount Program

                  Well Man Exams          SHICK (Medicare)Counseling              Community Resource Assistance

           Patient Portal                   Prescription Assistance      Diabetes Care & Prevention

               Family Planning               Smoking Cessation              Preventive Health Education

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Counties Served:

Sheridan, Decatur, Norton, Thomas, Wallace, Sherman, Gove, Graham, Logan, Rawlins, & Cheyenne.

Our Providers

Victor Nemechek, MD

Michael E. Machen, MD

Kerri Schippers, APRN

Kerri Schippers, APRN             Victor Nemechek, MD

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     VICKI                  RHONDA             TASHA & KRISTAL

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                                           Tasha, Rhonda, Kristal, Lisa, Whitney, Vicki

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               DR. MICHAEL MACHEN, MD

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HOXIE MEDICAL CLINIC

(A Federally Qualified Health Center)

                   GOVERNING BOARD OF TRUSTEES          

Keith Caldwell – Chair
Esther Bainter – Vice Chair
Joe Welshon- Secretary
Wade Tremblay – Treasurer
Harold Koster
Lucille Heim
Leanna Sloan
Mary Ellen Welshhon
Kou Lovin
Lisa Schamberger
Deb Wade

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If you are bringing your child in for a well-child exam, please click on the following link and on the left side of the page select, “BRIGHT FUTURES TOOL and RESOURCE KIT.” Select the appropriate age tool, open and print the correct “TOOL,” fill it out and bring it to your visit. (if you get a pop-up, just “cancel”)

Bright Futures Tool

View the provider schedule

Hours of Operation

Walk-ins: Monday – Friday from 7 a.m. to 08:30 a.m.
Appointments: Monday – Friday 9 a.m. to 4:45 p.m.

What you need to bring.

  • Picture ID card
  • Insurance card (if insured)
  • Copay-Credit/Debit Card, Cash, or Check
  • Medication list
  • Immunization Records (if applicable for appt.)

NEW PATIENTS: Please fill out the following Demographic Form and bring it to your first visit.  Also,        ESTABLISHED PATIENTS: Please fill out the Demographic Form & bring it with you to your FIRST VISIT in a NEW YEAR.  To better serve you, and to be compliant with federal regulations, we must update your information annually.

Demographic Form

More Forms

*Must be updated annually*

*Authorization for the release of your medical records to HMC*

ACKNOWLEDGMENT OF RECEIPT OF NOTICE

*Hoxie Medical Clinic’s Privacy Information Form*

Clinic HIPAA form[1]

Acknowledgment of receipt of notice of Privacy Information

authorization for release of info CLINIC

Contact Information

826 18th Street, Suite A
Hoxie, KS 67740-4373

or

P.O. Box 415
Hoxie, Ks. 67740

Phone: (785) 675-3018
Fax: (785) 675-2306