SGHA
Physician Listing
Allied Health
Practitioners
Plan Design Summary
ID Card
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
David Campbell
Audrey M. Hodge
B. Bret Law
John M. Raines
Michael P. Raines
Internal Medicine
Fleming Burroughs
James G. Herron
Khurram Kamran
Richard T. Oster
Frank H. Parrott
Cindy L. Phillips
Frank A. Wilson IV
K. Narasimha Reddy
Gary Rzeznik
Jamie Steinsapir
Yoo T. Suh
Steven Toro
Top
Pediatrics
Andrew C. Carlson
Judy Y. Y. Cheng
Claude Gauthier
Raymond C. Ho
Nelson T. Madrazo
Adriana Rzeznik
Anesthesiologist
Ali Fooman
Judy G. Johnson
Ear, Nose & Throat (ENT)
Gregory A. Garth
Emergency Medicine
Ben C. Andrews Jr.
Linda K. Hudson
Charles R. Sheffield
Top
Endocrinology
Jamie Steinsapir
Gastroenterology /Internal Medicine
Yoo T. Suh
General Surgery
Douglas R. Joiner
Harvey L. Simpson
Gynecology /Gynecologic Oncology
A. Gatewood Dudley
Top
Nephrology / Internal Medicine
K. Narasimha Reddy
Neurology
Shijun (James) Pan
Obstetrics and Gynecology
Michael L. Cacciatore
T. Schley Gatewood Jr.
Wallace D. Mays
Joseph W. King III
Beverly F. Womack
Ophthalmology
Chanh M. Tu
Top
Optometry
David A. Hart
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
Kenneth E. DiNella
Radiology
Michael H. Baldwin
Charles M. Davis
Louis M. Weinstein
Urology
Eugene S. Greenberg
Allied
Health Practitioners
(select Allied Health Practitioners to view the
listing)
Top
Plan Design Summary
| Plan Design |
In-Network |
Out-of-Network |
Comments |
| Lifetime Maximum |
information not available |
n/a |
none |
| Calendar Year Deductible |
no deductible |
$250 individual |
none |
| Out-of-Pocket Maximum Cost including Deductible |
information not available |
. |
refer to human resources |
| Physician Office Visits |
$15 co-pay |
70% |
none |
| In-House Physician (radiologist, pathologist,
anesthesiologist) |
100% |
70% |
none |
| Preadmission Testing |
100% |
70% |
none |
| Hospital Services |
$200 co-pay per inpatient admission |
70% |
none |
| Emergency Room Visit |
$50 co-pay |
70% |
deductible waived if admitted |
| Psychiatry / Drug / Alcohol
|
$200 co-pay (maximum 5/years)
100% 25,000 yearly maximum |
70%
100% 25,000 yearly maximum
|
none |
| Psychiatry / Drug / Alcohol
|
$15 co-pay
30 visits per calendar year |
50%
$1,000 calendar year maximum |
none |
| Wellness Benefit |
$15 co-pay |
not covered |
$500 maximum per person |
| Other Covered Expenses |
100% |
70% |
none |
|
|
80% |
not covered |
none |
|
|
80%
120 days per calendar year |
not covered |
none |
|
|
80% $5000 maximum |
not covered |
none |
|
|
80% |
not covered |
none |
ID Card
Obtain ID Card from patient to insure
benefit status.
Claims &
Eligibility
Secure Health
Claims Department
P.O. Box 13447
Macon, GA 31208-3447
1 (800) 648-7563
Pre-Certification
Requirements
1 (888) 633-5339
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
| 
