American Freightways

SGHA Physician Listing

Allied Health Practitioners

Plan Design Summary

Claims & Eligibility Information

Pre-Cert Requirements

Laboratory Instructions

Tertiary Referrals

Physician Listing

Primary Care Physicians Internal Medicine Pediatrics Anesthesiologist Ear Nose & Throat (ENT) Emergency Medicine Endocrinology Gastroenterology /Internal Medicine General Surgery Gynecology /Gynecologic Oncology Nephrology /Internal Medicine Neurology Obstetrics and Gynecology Ophthalmology Optometry Orthopedic Surgery Pathology Podiatry Psychiatry Radiology Urology

Primary Care Physicians

Michael S. Busman

Audrey M. Hodge

Michael P. Raines

Internal Medicine

Fleming Burroughs

James G. Herron

Richard T. Oster

Frank H. Parrott

Cindy L. Phillips

Frank A. Wilson IV

K. Narasimha Reddy

Jamie Steinsapir

Pediatrics

Andrew C. Carlson

Judy Y. Y. Cheng

Nelson T. Madrazo

Anesthesiologist

Judy G. Johnson

Ear, Nose & Throat (ENT)

Emergency Medicine

Ben C. Andrews Jr.

Linda K. Hudson

Charles R. Sheffield

Endocrinology

Jamie Steinsapir

Gastroenterology /Internal Medicine

General Surgery

Douglas R. Joyner

Harvey L. Simpson

Glenn E. Summers

Gynecology /Gynecologic Oncology

A. Gatewood Dudley

Nephrology / Internal Medicine

K. Narasimha Reddy

Neurology

Shijun (James) Pan

Obstetrics and Gynecology

Michael L. Cacciatore

T. Schley Gatewood Jr.

Wallace D. Mays

Beverly F. Womack

Ophthalmology

Optometry

Kenneth M. Moates

Valerie L. Moates

Ray D. Williams

Orthopedic Surgery

Robert A. Bartosh

Charles W. Davis

Pathology

Sandra L. Zornes

Podiatry

Leonard R. LaRussa

Psychiatry

Radiology

Urology

Eugene S. Greenberg

Allied Health Practitioners

(select Allied Health Practitioners to view the listing)

Plan Design Summary

Plan Design	In-Network	Out-of-Network	Comments
Lifetime Maximum	1,000,000	1,000,000	none
Calendar Year Deductible	$200 individual	$200 individual	none
Out-of-Pocket Maximum Cost including Deductible	$250	$1,200	none
Physician Office Visits	$10 co-pay (Primary Care) 90% after deductible (Specialist)	70% after deductible	none
In-House Physician (radiologist, pathologist, anesthesiologist)	90% after deductible	70% after deductible	none
Preadmission Testing	90% after deductible	70% after deductible	none
Hospital Services	90% after deductible	70% after deductible	none
Emergency Room Visit	90% after deductible	70% after deductible	none
Psychiatry / Drug / Alcohol Inpatient	50% after deductible	30% after deductible	none
Psychiatry / Drug / Alcohol Outpatient	50% after deductible $4000 calendar year maximum	30% after deductible $4000 calendar year maximum	none
Wellness Benefit	$10 co-pay, then %100	not covered	none
Other Covered Expenses	90% after deductible	70% after deductible	none
Spinal Manipulation	$300 calendar year maximum	$300 calendar year maximum	none
Home Health Care	90% after deductible	70% after deductible	none
Hospice Care	information unavailable refer to human resources	information unavailable refer to human resources	none
Physical/Speech Therapy	50% after deductible	30% after deductible	none

ID Card

Obtain ID Card from patient to insure benefit status.

Claims & Eligibility

Secure Health

Repricing Department

P.O. Box 4088

Macon, GA 31208-4088

1 (800) 648-7563

Pre-Certification Requirements

1 (800) 546-1900 extension 2839

Laboratory Instructions

Lab work performed by Sandra L. Zornes, MD and Southern Laboratory and Pathology Serviced, PC at Sumter Regional Hospital will be considered an in-network benefit.

Call Tommy Carter (924.6011, Extension 2394) to arrange for the courier service at the hospital to pick up your specimens for Dr. Zornes and the clinical laboratory.

Lab work performed at SGHA participating physician�s office will be considered an in-network benefit.

Lab work performed at Phoebe Putney Memorial Hospital or a Phoebe Health Partner�s physician�s office will be considered in-network.

Any other laboratory charges will be considered out-of-network.

Tertiary Referrals