Office Forms & Policies
Be prepared for your upcoming appointment with Phillips Pediatrics!
For your convenience, patient registration can be completed online or you can download forms here.
- Online Family Registration (Required for Each Family)
- Online Medical History Questionnaire (Required for Each Child)
- Online Authorization for Release of Medical Records to Phillips Pediatrics
To view the forms listed below, you will need to download Adobe Reader. Please bring your completed forms with you to our office at the time of your visit.
- Family Registration
- Practice Policies (Privacy, Financial, Treatment)
- Notice of Privacy Practices
- Medical History Questionnaire
- Authorization for Release of Medical Records
- Marketing Release Authorization
For your convenience, individualized visit forms are attached to your child’s online portal.
Billing & Insurance
We take all major insurances, including private, MS Medicaid, and CHIPS plans. We are in network with many insurance companies.
We are currently in network with Aetna, Blue Cross Blue Shield, CIGNA, Coventry, First Health, Golden Rule, Health Scope, Humana, Mail Handlers, Medishare, Multiplan, MS Medicaid, Magnolia, Molina, Molina CHIP, UnitedHealthcare, UnitedHealthcare MSCan, UnitedHealthcare MS CHIP, and TriCare.
If you do not see your plan listed, please call our billing office as we may be in a network not listed above.
Frequently Asked Questions
HIPPA requires an authorization for consent of medical records between institutions and providers. For your convenience, we’ve included a transfer of records request here.
We are in network with many insurance companies. If you do not see your plan listed, please call our office as we may be in network.
Aetna, Blue Cross Blue Shield, CIGNA, Coventry, First Health, Golden Rule, Health Scope, Humana, Mail Handlers, Medishare, Multiplan, MS Medicaid, Magnolia, Molina, UnitedHealthcare, and UnitedHealthcare MSCan.
We will be in network with TriCare. Please call the clinic for information on scheduling your child if you have one of these plans.
Most hospitals ask if you have a pediatrician when you go in to deliver. Your baby’s first examination will be with a pediatric hospitalist or on-call pediatrician. Upon discharge, either you or the nursery will need to schedule a newborn visit with Dr. Phillips.
Dr. Phillips will see your baby 2-3 days after discharge and regularly after that for checkups.
You typically have 30 days after birth to enroll your child in an insurance plan. We hold claims the first month of life as most plans backdate to birth.
Pediatricians devote their entire careers and training to the care of children. They undergo a minimum of three years of pediatric training after graduation from medical school. Pediatricians manage the health of your child, including physical, behavior, and mental health issues. Pediatricians work with parents to give guidance, support, and reassurance and should be a doctor with whom you trust and feel comfortable. In addition to routine health maintenance, we are the first person to call whenever you have a question or when your child is sick. The American Academy of Pediatrics recommends your child see a pediatrician from birth to the age of 21.
The foundation of osteopathic medicine is that people are more than just the sum of their body parts. Osteopathic physicians are known to take a hands on approach to diagnosis, a holistic approach to care, and a systems-based approach to treatment. There are 5 aspects of personal health: physical, emotional, social, spiritual, and intellectual. Osteopathic medicine focuses on the well-being of the entire person. This holistic approach to care has been a guiding principal for Dr. Phillips as a D.O.
Yes. We diagnose and manage ADHD as well as other common pediatric mental health issues, such as oppositional defiant disorder, depression, and anxiety. We have a counselor on site that allows for comprehensive care in the comfort of your pediatrician’s office. We also coordinate care with specialists and schools when needed. For optimal health, we require our ADHD patients to stay up-to-date with routine healthcare maintenance and vaccinations.
Yes, we are contractually obligated to collect insurance co-pays for each patient we see. For this reason, we require co-pays at the time of each visit. The person bringing your child to the office is responsible for the payment.
Private insurance plans vary. It is your responsibility to know your plan. CHIPS co-pays are listed on the back of your child’s insurance card.