Now Offering Weight Loss Management
Now Offering Weight Loss Management
To ensure you get the quality healthcare you deserve, we have established relationships with a variety of health insurance carriers. We accept most insurance plans including Medicare and Medicaid (see list below). We also welcome self-pay patients and all forms of payments such as cash and credit cards. Payment is expected for medical services rendered at the time of your visit. Co-payments and non-covered charges must be paid at each visit as stated by your plan. If any special arrangements are necessary, please ask to discuss them with our office.
Ambetter
Amerigroup
Aetna
Blue Cross Blue Shield
Cigna
CareSource
Humana
Medicaid
Medicare
Optum
PeachState
Tricare
Trustmark
United Healthcare
*If you do not see your insurance please verify with the office before making an appointment.
It is of vital importance that you complete a letter requesting financial assistance for your newborn immediately after delivery. When you receive your Eligibility Statement, you should bring it to the office. Ideally, your case worker should be notified prior to the delivery. If we do not receive your child’s Medicaid number and Eligibility Statement, you become responsible for our bill.
Request for Release (pdf)
DownloadHIPAA Consent (pdf)
DownloadPatient Registration Disclosure and Consents (pdf)
DownloadNotice of Privacy Practice (pdf)
DownloadMedical History (pdf)
DownloadPatient Registration Form (pdf)
DownloadPediatric Health History Questionnaire (pdf)
DownloadParental Pre-Authorization (pdf)
DownloadMitchell County Pediatrics and Health Center
94 East Oakland Avenue, Camilla, Georgia 31730, United States
Phone: 229.336.9769 Fax:229.336.3867
Designed by: Chasity Walker
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