Peerless Manufacturing

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	$200	none
Out-of-Pocket Maximum Cost including Deductible	information not available	information not available	none
Physician Office Visits	100% after $20 co-pay	information not available	none
In-House Physician (radiologist, pathologist, anesthesiologist)	100% after $20 co-pay	information not available	none
Preadmission Testing	100%	n/a	not subject to deductible
Hospital Services	90% after $250 deductible	n/a	deductible waived with pre-authorization
Emergency Room Visit	$100 co-pay	n/a	co-pay waived if admitted
Psychiatry / Drug / Alcohol Inpatient	60% after deductible 30 days maximum per calendar year	40%	10,000 maximum per calendar year 25,000 lifetime maximum
Psychiatry / Drug / Alcohol Outpatient	50% 50 visits maximum per calendar year	50%	10,000 maximum per calendar year 25,000 lifetime maximum
Wellness Benefit	60%	40%	not subject to deductible
Other Covered Expenses	60%	40%	none
Spinal Manipulation	$30 limit per visit 25 visits maximum per calendar year	information not available	none
Home Health Care	120 maximum visits per calendar year	.	none
Hospice Care	60% after deductible	40% after deductible	none
Physical/Speech Therapy	60% after deductible	40% 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) 422-7711

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