Family Intervention Specialists, Inc.
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Insurance

FIS is a facility contracted by Medicaid to provide mental health services to the Georgia Community. We accept Wellcare, Peachstate, Amerigroup and APS. We only accept Medicaid for insurance at this time but we do provide a sliding scale fee for patients that are uninsured or are with another provider.

For more information, please contact our administration office at 770-222-6622.

If you have a question that you would like to submit via email, please fill out the form below.

Full name:
Email address:
Comments:
 

To report suspected Medicaid Fraud or Unethical Behaviors please call the Family Intervention Medicaid Fraud Hotline at 1(866)673-0469.

You may also report fraud with the form below. Thank you.

Full name:
Email address:
Comments:
 



Know someone who needs services or do you need them yourself? Please fill out our referral form below. If you have any difficulties, please contact our administration office at 770-222-6622 to discuss a referral.

 

In order for a referral to be processed in a timely manner a valid SSN and/or Medicaid ID# is required.

If this information is invalid, it will delay the referral process.

Family Intervention Specialists Referral Form
Full name:
 * required
Address:
 * required

City:

 * required

Zip Code:

 * required
Contact number:
 * required
Social Security:
 * required
Date of Birth:
 * required
Race:
 * required
Gender:

Medicaid number (If available):

 * required

Other Insurance
(If applicable):

Other Insurance Number
(If applicable):

Name of school:

 * required

Grade:

 * required

Who does the child live with?

Guardian Name:

 * required

Is there anyone in the household currently receiveing services with FIS?

Current Medications:

Reason for referral:


Referral Source :

Name:

County for Referral:

 * required

P.O/Caseworker Name:

P.O/Caseworker Contact Number:

P.O/Caseworker Email Address:

Additional Comments:

   
 
   



Family Intervention Specialist
"Bridging the Gap Between Families and Communities"