Southern Regional Health System Employee

Transcription

1 Southern Regional Health System Employee Table of Contents UNDERSTANDING YOUR HEALTH PLAN...2 HMO HOSPITAL MAP...6 PARTICIPATING HOSPITALS...8 URGENT CARE CENTERS...11 ANCILLARY PROVIDERS...13 PRIMARY CARE PHYSICIANS...40 PARTICIPATING SPECIALIST PHYSICIANS...83 ACTIVHEALTHCARE CHIROPRACTIC TWORK MENTAL HEALTH/SUBSTANCE ABUSE PHYSICIAN INDEX...264

2 SOUTHERN REGIONAL HEALTH SYSTEM ASO Employee Health Plans Southern Regional Health System Employee Health Plans are administered by Coventry Health Care of Georgia, Inc. and will use this Provider and Hospital Directory. This section contains summary information only. Please refer to your Benefits Summary - Trifold Document and Summary Plan Description for a complete description of these plan benefits. Customer Service Coventry has a dedicated Customer Service Department for members who are participating in Southern Regional Health System s Employee Health Benefits. Please note that providers may have been added or deleted since this directory was printed. For the most current listing, please visit the Southern Regional Health System website located on the Coventry website at This site also provides detailed information regarding your benefit plan, covered services, prescription drug plan, and other answers to frequently asked questions. You can reach Coventry Customer Service at (866) Representatives are available to answer your questions, Monday through Friday, from 7:00 am to 6:00 pm EST. My Online Services You can manage your personal health privately, and you can check your personal health benefit information online when it is convenient for you! Your benefit information is available 24 hours a day, seven days a week. You have the ability to change your PCP; view eligibility and benefits; perform online provider search, and online pharmacy formulary search; check claims, preauthorizations, and referral status; set wellness reminders; access the Coventry WellBeing Self Care and Wellness Program; and print a temporary ID card. All active members can register by logging into the Southern Regional Health System website located on the Coventry website at Then click on the red Login/Register button on the left side of your screen to enter the password protected Member area. Then follow the easy instructions. HMO, Premier and Premier Plus Two-Tier Physician and Hospital Network The Southern Regional Health System HMO, Premier and Premier Plus Employee Plans contain 2 different benefit levels depending upon the network you access for your health services. It uses a two-tier network of physicians and hospitals. The 1 st tier network is the Southern Regional Health System Network, and is a subset of the Coventry Health Care of Georgia Network ( 2nd tier network). Choosing Primary Care doctors, specialists, and hospitals in the Southern Regional ASO network will generally result in

3 lower copays for you. PCP selection does not affect your ability to access both Coventry and Southern Regional ASO providers. The HMO and Premier Plans do not have out-ofnetwork benefits except in urgent and emergent situations. Primary Care Physician Your Primary Care Physician (PCP) acts as your personal physician coordinating all of your health care needs in the HMO plan only. In the HMO Plan, you must choose an innetwork Southern Regional ASO or Coventry PCP for yourself and each member of your family. Each family member can choose the same doctor or a different one it s your choice. If you choose a Southern Regional ASO Network Physician (1 st tier), you will be responsible for a lower copay than if you choose a Coventry Network Physician (2 nd tier). The name and phone number of the PCP you select will be listed on your Member ID card. If you do not see your Provider listed in this Directory, please refer to the Southern Regional Health System website located on the Coventry website at for the most current listing. Southern Regional Health System members enrolled in the Premier or Premier Plus plans are not required to choose a PCP. These plans are Open Access, which means you can selfrefer to an in-network primary care physician or specialist. Seeking Care from a Specialist Members enrolled in the HMO Plan, which require selection of a PCP, will need a verbal referral from their PCP to see a Specialist - with the exception of Dermatology, OB/Gynecology, Ophthalmology, Mental Health/Chemical Dependency and Chiropractic services. If you see a specialist without a referral from your PCP, you may be responsible for all or part of the charges. Members enrolled in the Premier and Premier Plus plans do not select a PCP and will not need a PCP referral to see a Specialist. We recommend keeping your PCP informed whenever you seek care from other providers even if a referral is not required. Premier Plus plan Members may seek services from an Out-of Network Provider according to plan guidelines and at a higher cost. Special Arrangement for Certain Pediatricians The Children s Health Network, Kids First Network, and Children s HealthCare of Atlanta are considered to be within the Southern Regional ASO (1 st tier) network, which has lower copays for medical services.

4 Vision Care Benefits Your benefit plan covers one routine vision examination every 12 months. You must use a participating ophthalmologist. Participating ophthalmologists are listed in the provider directory and do not require a PCP referral. Please note: This benefit does not include discounts or benefits covering the purchase of glasses or contacts. Using your Mental Health and Chemical Dependency Services All members who are participating in Southern Regional Health System s Employee Health Benefits are eligible for Mental Health/Chemical Dependency as described in the Summary Plan Description and Benefit Summary. Medically Necessary outpatient Mental Health/Chemical Dependency office visits are limited to a combined maximum of 30 visits per member in any Benefit Year without a referral. You can access your Mental Health/Chemical Dependency services, administered by American Psych Systems (APS), directly through a toll-free number (877) Mental Health providers are not listed in this directory. You may also access the APS provider search at User logon is Coventry of Georgia HMO. An authorization from APS is required for inpatient, outpatient and residential hospital services. Please contact APS for a current listing of Coventry participating Mental Health providers or to seek an authorization for inpatient or outpatient hospital services. Failure to obtain authorization may result in non-payment for services or reduction in the benefits available to you. American Psych Systems (APS) business hours are 8 am to 6 pm EST; however, emergency services are available 24 hours a day, 7 days a week. Using your Chiropractic Benefit Spinal manipulations are only available through the ActivHealthCare Network of providers. There is no out-of-network benefit for this service. Benefits are limited to one visit per day and a maximum of 20 visits per Benefit Year per member. Chiropractors are listed in a separate section of the directory. For a current listing visit the ActivHealthCare website at Auto liability cases are excluded under the chiropractic benefit. Seeking Care in an Emergency Under the Plans, you are covered for medically necessary emergencies that occur when you are in or out of the Southern Regional ASO or Coventry Network service area. Emergency Services means those health care services that are provided for a condition of recent onset and sufficient severity, including, but not limited to, severe pain that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that his/her condition, sickness or injury is of such a nature that failure to obtain immediate medical care could result in: Placing the Member s health in serious jeopardy; Placing the health of a pregnant Member and the health of her unborn child in serious jeopardy; Serious impairment to bodily function; or Serious dysfunction of the body. In short, this means Emergency Services are considered Medically Necessary where a prudent layperson, acting reasonably, would have believed that an emergent medical condition existed.

5 If you receive services in an emergency room and those services are determined to be not medically necessary, the emergency room claim may be denied and you may be held financially responsible for the entire bill. In a medical emergency, go to the nearest medical facility/hospital, or dial 911 for treatment. Call (or have someone call) your PCP within 48 hours or as soon as possible! If you are in a Plan that does not require selection of a PCP, call Coventry Customer Service at (866) When Hospital Care is Needed Should you need inpatient hospital care or outpatient care, your admitting Physician will obtain an authorization, if needed, from Coventry Health Care of Georgia and arrange hospital care for you. Please remind your physician that you need to go to either a Coventry network hospital in order to get in-network benefits, or to a Southern Regional ASO hospital within the Coventry network to get in-network benefits at the lowest copay. Before an elective admission, it is your responsibility to ensure that the authorization is obtained and that you are aware that your financial responsibility will depend upon the participation status of the facility. When to pay Copayment/Coinsurance/Deductible Please pay any copayment at the provider s office when you receive medical care. Your provider may choose to collect some or all of your coinsurance or deductible payments at the time of service. HIPAA Notification and Authorized Representative Coventry Health Care, Inc. will make sure that your personal health information (PHI) is only used and shared consistent with HIPAA standards. Our current notice is posted at If you would like to designate a person to receive information about your benefits or to have access to your PHI, please contact Coventry Customer Service to obtain a Member Designated Release of Information Form. IT IS YOUR RESPONSIBILITY TO ENSURE YOUR PHYSICIAN REFERS YOU TO OTHER IN-TWORK PROVIDERS. PLEASE CONTACT COVENTRY HEALTH CARE, INC. AT IF YOU HAVE ANY QUESTIONS ABOUT THE TWORK STATUS OF YOUR PHYSICIAN PROVIDERS.

6 575 Coventry Health Care of Georgia Southern Regional ASO Hospitals Children s Healthcare of Atlanta - Scottish Rite* Children s Healthcare of Atlanta - Egleston* Riverwoods Psychiatric Center Southern Regional Medical Center 75 For an up to date listing of providers please check our web site at Georgia HMO As of 01/06 *Part of Southern Regional Health System ASO for lower copay

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8 Participating Hospitals APPLING BUTTS CLAYTON DEKALB EMANUEL Appling Healthcare System 163 E Tollison St Baxley, GA (912) BARROW Barrow Community Hospital 316 N Broad St Winder, GA (770) BARTOW Cartersville Medical Center 960 Joe Frank Harris Pkwy SE P.O. Box Cartersville, GA (770) BIBB Medical Center of Central Georgia (478) BLECKLEY Bleckley Memorial Hospital 145 E Peacock St Cochran, GA (912) BULLOCH East Georgia Regional Med Ctr 1499 Fair Rd Statesboro, GA (912) BURKE Burke Medical Center 351 S Liberty St Waynesboro, GA (706) Sylvan Grove Hospital 1050 McDonough Rd Jackson, GA (770) CANDLER Candler County Hospital 400 Cedar St Metter, GA (912) CARROLL Tanner Medical Center 705 Dixie St (770) Tanner Medical Ctr-Villa Rica 601 Dallas Hwy Villa Rica, GA (770) CHATHAM Candler Hospital 5353 Reynolds St (912) St. Joseph's/Candler Hlth Syst Mercy Blvd Savannah, GA (912) CHEROKEE Northside Hospital - Cherokee 201 Hospital Rd (770) CLARKE St. Mary's Health Care System 1230 Baxter St (706) Anchor Hospital 5454 Yorktowne Dr Atlanta, GA (770) Riverwoods Psychiatric Center 11 Upper Riverdale Rd SW (770) Southern Crescent Hospital for Specialty Care 11 Upper Riverdale Rd SW 6th Floor (770) Southern Regional Medical Center 11 Upper Riverdale Rd SW (770) COBB Emory-Adventist Hospital 3949 S Cobb Dr SE Smyrna, GA (770) Ridgeview Institute 3995 S Cobb Dr SE Smyrna, GA (770) WellStar Cobb Hospital 3950 Austell Rd (770) WellStar Kennestone Hospital 677 Church St (770) WellStar Windy Hill Hospital 2540 Windy Hill Rd SE Marietta, GA (770) COWETA Newnan Hospital-West 60 Hospital Rd Newnan, GA (770) Children's Healthcare of Atlanta at Egleston 1405 Clifton Rd (404) Decatur Hospital 450 N Candler St Decatur, GA (404) DeKalb Medical Center 2701 N Decatur Rd (404) DeKalb Medical Center - Hillandale 2801 Dekalb Medical Pkwy Lithonia, GA (404) Emory University Hospital 1364 Clifton Rd (404) Peachford Behavioral Hlth Syst 2151 Peachford Rd Atlanta, GA (770) DODGE Dodge County Hospital 901 Griffin Ave Eastman, GA (478) DOUGLAS Inner Harbour Hospitals 4685 Dorsett Shoals Rd Douglasville, GA (770) WellStar Douglas Hospital 8954 Hospital Dr Frnt (770) EFFINGHAM Effingham Hospital 459 Ga Highway 119 S Springfield, GA (912) Emanuel County Hospital 117 Kite Rd Swainsboro, GA (478) EVANS Evans Memorial Hospital 200 N River St Claxton, GA (912) FAYETTE Piedmont Fayette Hospital 1255 Hwy 54, W (770) FLOYD Floyd Medical Center 304 Turner McCall Blvd SW (706) Redmond Regional Medical Ctr 501 Redmond Rd NW (706) The Specialty Hospital 304 Turner McCall Blvd SW (706) FORSYTH Northside Hospital Forsyth 1200 Baptist Medical Center Dr (770) FULTON Atlanta Medical Center 303 Parkway Dr (404) Children's Healthcare Atlanta 1001 Johnson Ferry Rd (404)

9 Participating Hospitals Participating Hospitals Crawford Long Hosp Emory Univ 550 Peachtree St (404) Emory Johns Creek Hospital 6325 W Johns Xing (678) Grady Memorial Hospital 80 Butler Street SE North Fulton Regional Hospital 3000 Hospital Blvd (770) Northside Hospital 1000 Johnson Ferry Rd (404) Piedmont Hospital 1968 Peachtree Rd NW (404) Saint Joseph's Hosp of Atlanta 5665 Peachtree Dunwoody Rd (404) Shepherd Center 2020 Peachtree Rd NW (404) South Fulton Medical Center 1170 Cleveland Ave Atlanta, GA (404) GILMER North Georgia Medical Center 1362 S Main St Ellijay, GA (706) GLYNN Focus Healthcare of Georgia, LLC 2927 Demere Rd Saint Simons Island, GA (912) GORDON Gordon Hospital 1035 Red Bud Rd Calhoun, GA (706) GREE Minnie G Boswell Mem Hospital 1201 Siloam Rd Greensboro, GA (706) GWINTT Emory Eastside Medical Center 1700 Medical Way (770) Gwinnett Hospital System 1000 Medical Center Blvd (770) Joan Glancy Memorial Hospital 3215 McClure Bridge Rd (678) HALL Laurelwood Hospital 200 Wisteria Dr (770) Northeast Georgia Medical Center-Lanier Park Campus 675 White Sulphur Rd (678) Northeast Georgia Medical Ctr 743 Spring St (770) HARALSON TMC/Higgins General Hospital 200 Allen Memorial Dr Bremen, GA (770) HENRY Henry Medical Center 1133 Eagles Landing Pkwy (678) HOUSTON Houston Medical Center 1601 Watson Blvd Warner Robins, GA (912) Perry Hospital 1120 Morningside Dr Perry, GA (478) JACKSON BJC Medical Center 70 Medical Center Dr Commerce, GA (706) JASPER Jasper Memorial Hospital 898 College St Monticello, GA (706) LIBERTY Liberty Regional Medical Ctr 462 E G Parkway Hinesville, GA (912) LOWNDES South Georgia Medical Center 2501 N Patterson St Valdosta, GA (229) LUMPKIN Chestatee Regional Hospital 227 Mountain Dr Dahlonega, GA (706) MERIWETHER Warm Springs Medical Center 5995 Spring St Warm Springs, GA (706) MONROE Monroe County Hospital 88 Martin Luther King Jr Dr Forsyth, GA (912) MORGAN Morgan Memorial Hospital Canterbury Park Madison, GA (706) MUSCOGEE St. Francis Hospital, Inc 2122 Manchester Expy (706) The Medical Center 710 Center St Columbus, GA (706) WTON Newton Medical Center 5126 Hospital Dr Covington, GA (770) PAULDING WellStar Paulding Hospital 600 W Memorial Dr Dallas, GA (770) PEACH Peach Regional Medical Center 601 N Camellia Blvd Fort Valley, GA (478) PICKENS Piedmont Mountainside Hospital, Inc 1266 Highway 515 S Jasper, GA (706) POLK Polk Medical Center 424 N Main St Cedartown, GA (770) RICHMOND Doctors Hospital 3651 Wheeler Rd (706) Medical Clg of Georgia Hosp (706) St. Joseph Hospital 2260 Wrightsboro Rd Augusta, GA (706) University Health Care System 1350 Walton Way (706) ROCKDALE Rockdale Hospital & Hlth Syst 1412 Milstead Ave Conyers, GA (770) SCREVEN Screven County Hospital 215 Mims Rd Sylvania, GA (912) SPALDING Spalding Regional Hospital 601 S 8th St (770) TATTNALL Tattnall Memorial Hospital Route 1 Reidsville, GA (912) TOOMBS Meadows Regional Medical Ctr 1703 Meadows Ln Vidalia, GA (912)

10 Participating Hospitals Participating Hospitals WALTON Walton Medical Center 330 Alcovy St Monroe, GA (770) WARE Satilla Regional Medical Ctr 410 Darling Ave Waycross, GA (912) WAY Wayne Memorial Hospital 865 S 1st St Jesup, GA (912)

11 Urgent Care Centers BIBB Med Center - East 1339 Gray Hwy Macon, GA (478) Med Center - North 3400 Riverside Dr Macon, GA (478) Med Center - West 711 Eisenhower Pkwy Macon, GA (478) Med Center-Northwest 5925 Zebulon Rd Macon, GA (478) Pediatrics After Hours 3400 Riverside Dr Macon, GA (706) CHATHAM Concentra Urgent Care 109 Minis Ave Suite C-10 Savannah, GA (912) Georgia Emergency Associates Immediate Care Center 361 Commercial Dr Savannah, GA (912) CHATTOOGA Floyd Urgent Care Highway 27 Summerville, GA (706) CHEROKEE Immediate MedCare of Woodstock Highway 92 0 Woodstock, GA (770) Physicians' Immediate Med of Canton PC 720 Transit Ave (770) WellStar Urgent Care at Towne Lake, LLC 120 Stonebridge Pkwy (678) CLAYTON Children's Healthcare of Atlanta at Mount Zion 2201 Mount Zion Pkwy Morrow, GA (404) COBB Children's Healthcare of Atlanta at Town Center 2985 George Busbee Pkwy NW Kennesaw, GA (404) Concentra Urgent Care 220 Cobb Pkwy N Ste 400 Marietta, GA (770) Physicians' Immediate Med 2481 George Busbee Pky Kennesaw, GA (770) WellStar Urgent Care in Kennesaw, LLC 3805 Cherokee St NW Kennesaw, GA (770) WellStar Urgent Care on Delk Road, LLC 2890 Delk Rd SE Marietta, GA (770) WellStar Urgent Care on Sandy Plains Road, LLC 3600 Sandy Plains Rd Marietta, GA (770) COLUMBIA University Hospital Prompt Care Columbia County 447 N Belair Rd Evans, GA (706) COWETA Summit Healthplex 1755 Highway 34 E Newnan, GA (770) DAWSON Physicians' Immediate Med of Dawsonville, P.C. 91 Nordson Overlook Dawsonville, GA (706) DEKALB Community Care, PC 5019 Lavista Rd (404) Emory Student Health Center 2711 Irvin Way Suite 111 Decatur, GA (404) Hillandale Minor Emergency Center 5910 Hillandale Dr Suite 103 Lithonia, GA (770) ICCS dba Toco Hills Urgent Care 3019 N Druid Hills Rd Atlanta, GA (404) DOUGLAS Physicians' Immediate Med of Douglasville PC 9390 The Landing Dr Douglasville, GA (770) TMC Immediate Care, Inc Highway 5 Ste E (770) EFFINGHAM Effingham Hospital MedCare 100 Goshen Rd Rincon, GA (912) FANNIN Immediate Medcare of Riverstone, LLC 101 Riverstone Vis Ste 106 Blue Ridge, GA (706) FLOYD Floyd Urgent Care 304 Shorter Ave NW (706) FULTON Children's Healthcare of Atlanta at North Point 3795 Mansell Rd Alpharetta, GA (404) Concentra Urgent Care 3580 Atlanta Ave Atlanta, GA (404) Physicians' Immediate Med Haynes Bridge Rd Alpharetta, GA (770) U.S. Healthworks Medical Group of Georgia, PC 900 Holcomb Bridge Rd (770) GWINTT Children's Healthcare of Atlanta at Satellite Blvd 2660 Satellite Blvd (404) Concentra Urgent Care 1905 Beaver Ruin Rd Ste 175 Norcross, GA (770) Physicians' Immediate Med 3551 Satellite Blvd (770) Physicians' Immediate Med of Buford, P.C Buford Dr Buford, GA (678)

12 Urgent Care Centers Urgent Care Centers Premier Immediate Care of Georgia, PC 2696 Lawrenceville Suwanee Rd (678) HALL Guilford Immediate Care 1250 Jesse Jewell Pkwy SE Suite 400 (770) Urgent Care Friendship 4889 Golden Pkwy Buford, GA (678) HENRY Brightpoint Urgent Care, LLC 1365 Rock Quarry Rd (770) Minor Emergency Care 101 Regency Park Dr Mcdonough, GA (770) Spalding Regional Urgent Care Center at Heron Bay L.L.C Highway 155 Locust Grove, GA (678) Pediatrics After Hours th St Columbus, GA (706) Regional Urgent Care th Ave Ste F Columbus, GA (706) PAULDING Physicians' Immediate Med of Hiram PC 3827 Jimmy Lee Smith Pkwy Hiram, GA (770) POLK Floyd Urgent Care 1025 N Main St Cedartown, GA (770) HOUSTON Houston Lake Med-Stop 2510 Hwy 127 Kathleen, GA (478) Pavillion Med-Stop 233 N Houston Rd Warner Robins, GA (478) LOWNDES Convenient Care - Valdosta 2330 N Ashley St Valdosta, GA (229) MUSCOGEE Acute Care Express 7901 Veterans Pkwy Columbus, GA (706)

13 Ancillary Providers APPLING BARROW Ancillary Hospice Rehabilitation Therapy Facility Dialysis Center Durable Medical Equipment Certified Respiratory Services, Inc. 88 Heritage St Baxley, GA (912) BALDWIN Dialysis Center Milledgeville Dialysis 400 S Wayne St Milledgeville, GA (478) Durable Medical Equipment Georgia Medical Equipment and Respiratory Services, Inc N Columbia St Suite 109 Milledgeville, GA (478) Medical Imaging A Diagnostic Radiology Network Facility 1850 N Columbia St Suite 3 Milledgeville, GA (800) Physical Therapy Serenity Wellness Spa 107 Sportsman Club Rd Milledgeville, GA (478) BANKS Dialysis Center Fresenius Medical Care River City 2443 brookstone court ste B (706) Dialysis Center Barrow County Dialysis Center 189 W Athens St Ste 9 Winder, GA (770) Physical, Speech, Occup Therapy Physiotherapy Associates 137 N Broad St Ste E Winder, GA (770) Radiology Barrow Community Hospital 316 E Broad St P O Box 688 Winder, GA (770) Sleep Disorders Preferred Diagnostic Sleep Centers, Inc. Barrow Medical Ctr 316 N Broad St (Hwy 81) Winder, GA (770) BARTOW Ambulatory Surgery Center Center for Orthopedic Surgery 15 Medical Dr Cartersville, GA (770) Georgia Pain Spine Center 15 Medical Dr Ste 302 Cartersville, GA (678) American Wellness Diagnostics 31 Pointe North Dr Suite 105 Cartersville, GA (713) Dialysis Center BMA-Cartersville 14 Roving Rd Cartersville, GA (770) Durable Medical Equipment Apria Healthcare, Inc. 945 Joe Frank Harris Pkwy SE Cartersville, GA (770) Fuller Rehabilition Independent Living Aids- Cartersville 440 Cherokee Pl Cartersville, GA (770) Hanger Prosthetics & Orthotics, Inc. 17B Felton Pl Cartersville, GA (770) Phillips Medical Equipment, LLC 144 Kelli Clark Ct SE Cartersville, GA (678) Emergency Medicine Cartersville Emergency Physicians 960 Joe Frank Harris Pkwy SE Cartersville, GA (800) Home Health Agency Healthfield Home Health Inc 321 N Main St Adairsville, GA (770) In Home Health, Inc 319 E Church St Cartersville, GA (770) Occupational Therapy Hand Therapy Services 5 Medical Dr Cartersville, GA (706) Physical Therapy Rehab Associates 695 Henderson Dr Cartersville, GA (770) Physical, Speech, Occup Therapy BenchMark Physical Therapy 939 Joe Frank Harris Pkwy SE Cartersville, GA (770) Prosthetics/Orthotics Apria Healthcare, Inc. 945 Joe Frank Harris Pkwy SE Cartersville, GA (770) Hanger Prosthetics & Orthotics, Inc. 17B Felton Pl Cartersville, GA (770) Radiology Cartersville Diagnostic Center, LLC 21 Pointe North Dr Ste 105 Cartersville, GA (770) Reed Imaging Services LLC 15 Medical Dr Ste 102 Cartersville, GA (678) Advance Rehabilitation of Adairsville 10 Legacy Way Ste E Adairsville, GA (770) BEN HILL Prosthetics/Orthotics Southern Physical & Occupational Therapy Services Inc 112 N Main St P O Box 557 Fitzgerald, GA (229) BIBB Ambulatory Surgery Center Central Georgia Head & Neck Surgery Center 540 Hemlock St (478) Endoscopy Center of Middle Georgia, LLC 610 3rd St (478) Macon Outpatient Surgery, LLC 840 Pine St Ste 840 (478) Medical Eye Associates, Inc Oglethorpe St (478) Ancillary Health Services of Central Georgia HB #230 (478) MedCross Imaging PC 1818 Forsyth St (478) BMA-Macon 280 Clinton St Macon, GA (478) Dialysis Center of Middle Georgia-Macon 747 2nd St (912) Dialysis Treatment Centers of Macon 745 Pine St (912) East Macon Dialysis 750 Baconsfield Dr Ste 103 Macon, GA (912) FMC Dialysis Services-South Macon nd St Macon, GA (478) Renal Treatment Centers- Midtown Macon Dialysis Center 657 Hemlock St (912) Durable Medical Equipment Apria Healthcare, Inc. 182 Steven Dr Macon, GA (478) C.H. Martin 130 College St (478) ChiChesters Homecare Inc Gray Hwy Macon, GA (478) DJO, LLC 291 Plantation Centre Dr N Suite 1907 Macon, GA (800) Lincare, Inc 770 Baconsfield Dr Bldg 1, Macon, GA (478) Mediquip Rehabilitative Equipment & Supplies 808 Pio Nono Ave Macon, GA (478) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the web at 13

14 Ancillary Providers Bibb County Durable Medical Equipment Pediatric Services of America 770 Baconsfield Dr Bldg 1, Macon, GA (478) Pediatric Services of America, Inc 770 Baconsfield Dr Building 1, Ste. 100 Macon, GA (478) SleepMed Incorporated (478) SleepMed, Inc 770 Hemlock St (800) Southern Home Respiratory Care 466 Poplar St (478) Home Health Agency Central Georgia Home Care Services, Inc 3780 Eisenhower Pky Ste 5 Macon, GA (478) Pediatric Services of America, Inc 770 Baconsfield Dr Building 1, Ste. 100 Macon, GA (478) Physician Support Associates, Inc 1021 Daisy Pk (478) Laboratory Quest Diagnostics-Macon 446 Poplar St (478) Medical Imaging MedCross Imaging, PC 1818 Forsyth St (770) Physical, Speech, Occup Therapy Physiotherapy Associates 6501 Peake Rd Bldg 100 Macon, GA (478) Prosthetics/Orthotics Apria Healthcare, Inc. 182 Steven Dr Macon, GA (478) DJO, LLC 291 Plantation Centre Dr N Suite 1907 Macon, GA (800) Radiology Central Georgia MRI, LLC 5925 Zebulon Rd Macon, GA (478) Central Georgia PET, LLC 1650 Hardeman Ave (478) Children's Radiology of Atlanta 833 Walnut St (877) Open Macon Imaging Center 833 Walnut St (478) Open MRI of Macon 1504 Hardeman Ave (478) Hardeman Ave (478) Open MRI of Macon, LLC 2140 Riverside Dr Macon, GA (478) Radiology Center of Macon, LLC 833 Walnut St (478) Sleep Disorders Sleep Services of America, Inc 215 Sheraton Blvd & B Macon, GA (478) SleepMed Incorporated (478) SleepMed Therapies, Inc 800 1st St SleepMed, Inc 770 Hemlock St (800) Southern Sleep Technologies 466 Poplar St (478) BRYAN Rehabilitation Therapy Facility West Rehab Services, Inc 9964 Ford Ave Richmond Hill, GA (912) West Rehab Services, Inc. 205 E Bacon St Pembroke, GA (912) BULLOCH Dialysis Center FMC of Bullouch County 1355 Brampton Ave Statesboro, GA (912) Renal Treatment Centers- East Georgia Dialysis 450 Georgia Ave Statesboro, GA (912) Durable Medical Equipment Apria Healthcare, Inc. 16 College Plz Statesboro, GA (912) Georgia Home Medical 606 S Zetterower Ave Statesboro, GA (912) Hanger Prosthetics & Orthotics East, Inc 144 Northside Dr E Statesboro, GA (912) Walker Home Medical 206 Northside Dr W Suite 1 Statesboro, GA (912) Home Health Agency Ogeechee Home Health Agency, Inc Fair Rd Suite C Statesboro, GA (912) Orthotics Apria Healthcare, Inc. 16 College Plz Statesboro, GA (912) Physical Therapy Southern Wellness and Rehab B. Highway 80 East Statesboro, GA (912) Prosthetics/Orthotics Apria Healthcare, Inc. 16 College Plz Statesboro, GA (912) Radiology Statesboro Imaging Center, PC 8 Lester Rd Statesboro, GA (912) Rehabilitation Southern Sports Medicine & Rehabilitation 911 E Inman St Statesboro, GA (912) BURKE Diabetic Durable Medical Equipment University Home Health Services 77 US Highway 25 S Waynesboro, GA (706) Home Health Agency University Home Health Services 77 US Highway 25 S Waynesboro, GA (706) Physical, Speech, Occup Therapy University Home Health Services 77 US Highway 25 S Waynesboro, GA (706) BUTTS Dialysis Center Grovepark Dialysis 794 McDonough Rd Jackson, GA (770) Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 464 W 3rd St Ste 107 Jackson, GA (770) CAEN Physical, Speech, Occup Therapy Advance for Kids, Inc 100 Lindsey Ln Kingsland, GA (912) Rehabilitation Therapy Facility Advance Rehabilitation of Kingsland 100 Lindsey Ln Kingsland, GA (912) Kingsland Physical Therapy 130 N Gross Rd Ste 202 Kingsland, GA (912) CANDLER Dialysis Center FMC Candler County Dialysis 380 Sconyers St Metter, GA (912) Rehabilitation Better Living Services, Inc 8 N Williams St Metter, GA (912) CARROLL Ambulatory Surgery Center Carrollton Eye Clinic Ambulatory Surgery Center 158 Clinic Ave (770) West Georgia Endoscopy Center 160 Clinic Ave (770) Ancillary Minor Emergency & Family Medicine 209 Cooley Dr Suite 101 Villa Rica, GA (770) Dialysis Center Bio-Medical Applications of Carrollton 195 Parkwood Cir (770) FMCNA Villa Rica 130 Prospecter Dr Facility # 3846 Villa Rica, GA (770) Fresenius Medical Care- Carroll County 157 Clinic Ave Ste 102 (770) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the web at 14

15 Ancillary Providers Chatham County Home IV Infusion Agency Home Health Agency Tanner Medical Center Home Health, Inc. 100 Professional Pl Ste 303 (770) Hospice Tanner Medical Center Hospice Care, Inc. 122 Lee St (770) Physical Therapy Accel Physical Therapy 2000 Mirror Lake Blvd Ste F, Box 160 Villa Rica, GA (770) Physical, Speech, Occup Therapy Physiotherapy Associates 100 Professional Pl Ste 108 (770) Southern Therapy Service 812 S Park St (770) Southern Therapy Services 690 Dallas Hwy Ste 203 Villa Rica, GA (770) Southern Therapy Services, Inc 99 Doctors Dr (770) Prosthetics/Orthotics American Prosthetics Inc 1004 Bankhead Hwy Ste 14 (770) Atlanta Prosthetics & Orthotics, Inc N Park St Suite D (770) Radiology Children's Radiology of Atlanta 805 Dixie St (770) Open Carrollton Imaging Center 805 Dixie St (770) Rehabilitation Therapy Facility Matrix Rehabilitation- Georgia, Inc 1004 Bankhead Hwy Bldg A Ste 5 (770) Skilled Nursing Facility IHS at Carrollton Nursing & Rehabilitation Center 2327 N Highway 27 (770) IHS at Pine Knoll Nursing & Rehabilitation Center 156 Pine Knoll Dr (770) CATOOSA Durable Medical Equipment American Home Patient 435 Cloud Springs Rd Rossville, GA (706) American Homepatient 435 Cloud Springs Rd Rossville, GA (229) Fuller Rehabilition Independent Living Aids 529 Rollins Industrial Blvd Ringgold, GA (706) Oxygen & More 11 S Commerce Dr Ringgold, GA (706) Physical, Speech, Occup Therapy BenchMark Physical Therapy-Fort Oglethorpe 1394 Battlefield Pkwy Fort Oglethorpe, GA (706) CHARLTON Rehabilitation Advance Rehabilitation of Folkston 1203 N 3rd St Folkston, GA (912) CHATHAM Ambulatory Surgery Center Endoscopy Center of Coastal Georgia 519 Stephenson Ave (912) ENT Surgical Center Abercorn St Ste 2 Savannah, GA (912) Georgia Center for Digestive Diseases, LLC 501 Eisenhower Dr Savannah, GA (912) Orthopedic Surgery Center 210 E De Renne Ave (912) Plastic Surgery Centerland 5361 Reynolds St (912) Savannah Outpatient Foot & Ankle Surgery Center 310 Eisenhower Dr Building 7B Savannah, GA (912) Savannah Pain Center, LLC 8 Wheeler St ste 200 (912) Schulze Surgery Center 728 E 67th St (912) Shankliln Plastic Surgery Center, LLC 900 Mohawk St Savannah, GA (912) The Endoscopy Center, LLC 1139 Lexington Ave Savannah, GA (912) Urology Surgery Center of Savannah, LLLP 230 E De Renne Ave (912) Ancillary Coastal Empire Imaging 529 Stephenson Ave Ste 5 (912) Audiology Coastal Audiology, Inc 138 Canal St Ste 108 Pooler, GA (912) Diabetic Durable Medical Equipment Savannah Diabetic Supplies 7025 Hodgson Memorial Dr Savannah, GA (866) Dialysis Center Bio-Medical Applications Coastal Dialysis Center 1460 E Victory Dr Savannah, GA (912) RAI Drayton Savannah 1020 Drayton St Savannah, GA (912) West Chatham Dialysis Center 343 Main St Savannah, GA (912) Durable Medical Equipment American Homepatient 7602 Waters Ave Savannah, GA (912) Apria Healthcare, Inc. 901 E 65th St (912) C.H. Martin 7135 Hodgson Memorial Dr Ste 1-B Savannah, GA (912) Coastal Home Respiratory 409 E Montgomery Xrd Ste 5A Savannah, GA (912) Fuller Rehabilition Independent Living Aids- Savannah Mercy Blvd Bldg 3 Savannah, GA (912) Medi Home Advantage 5353 Reynolds St Ste 107 (912) Medi Home Care 4131 Ogeechee Rd Ste 123 (912) Chatham Center Dr Ste 2200 (912) Medical Infusion Technologies, Inc 115 Echols Ave Savannah, GA (912) Peachtree Medical Equipment 3326 Skidaway Rd Savannah, GA (912) Pediatric Services of America, Inc 37 W Fairmont Ave Unit 204 Savannah, GA (912) Renewal At Lewis Center/St Joseph/Candler Hosp 225 Candler Rd Ste 102 (912) Savannah Orthotics & Prosthetics, Inc. 906 E 68th St (912) Sleep Well, LLC 340 Hodgson Ct Bldg 200 Ste 2 Savannah, GA (912) Walker Home Medical 1100 Eisenhower Dr Suite 19 Savannah, GA (912) General Acute Care Hospital Sempercare Hospital of Savannah, Inc Reynolds St (912) Hearing Aid, Sales & Repair Savannah Speech and Hearing Center 1206 E 66th St Savannah, GA (912) Home Health Agency American Homepatient 7602 Waters Ave Savannah, GA (912) Gentiva Health Services Inc 329 Commercial Dr Ste 130 Savannah, GA (912) Gentiva Health Services Savannah 329 Commercial Dr Suite 130 Savannah, GA (912) Healthcare Principals Group, LLC 138 Canal St Ste.207 Pooler, GA (912) Pediatric Services of America, Inc 37 W Fairmont Ave Unit 204 Savannah, GA (912) Secure Care, Inc. 351 Commercial Dr Savannah, GA (912) St. Joseph's Candler Home Healthcare 5510 Paulsen St (912) Home IV Infusion Agency American Homepatient 7602 Waters Ave Savannah, GA (912) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the web at 15

16 Ancillary Providers Chatham County Home IV Infusion Agency Infusion Partners 1000 Business Center Dr Ste 120 (912) Medical Infusion Technologies, Inc 115 Echols Ave Savannah, GA (912) Venous Access Services, LLC 1 Johnston St Unit 6 (912) Hospice Hospice Savannah, Inc 1352 Eisenhower Dr Savannah, GA (912) Laboratory Quest Diagnostics - Savannah 340 Eisenhower Dr Ste 1480 Savannah, GA (912) Quest Diagnostics- Savannah 340 Eisenhower Dr Ste 1480 Savannah, GA (912) Quest Diagnostics- Savannah Medical District 815 E 68th St (912) Medical Imaging Boland Women's Imaging PC 1615 E Montgomery Xrd Savannah, GA (912) Occupational Therapy Pediatric Therapies of Savannah 6555 Abercorn St ste 221 (912) Physical, Speech, Occup Therapy Candler Hospital 5353 Reynolds St (912) Coastal Therapy, Inc. 911 E 70th St (912) St. Joseph's/Candler Hlth Syst Mercy Blvd Savannah, GA (912) Prosthetics/Orthotics Apria Healthcare, Inc. 901 E 65th St (912) Radiology Open MRI of Savannah 4815 Waters Ave Savannah, GA (912) PET Imaging Center of Savannah, LLC 7135 Hodgson Memorial Dr Ste 10A Savannah, GA (770) Radiology Associates of Savannah, PC 5105 Paulsen St Suite C140 (912) Savannah Chatham Imaging Services Mercy Blvd Savannah, GA (912) Rehabilitation Recovery Place 835 E 65th St (912) Rehabilitation Therapy Facility West Rehab Services Inc 1000 Towne Center Blvd Ste 602 Pooler, GA (912) West Rehab Services, Inc 109-C Minus Ave Savannah, GA (912) West Rehab Services, Inc. 100 Blue Fin Cir Ste 3 Savannah, GA (912) Eisenhower Dr Savannah, GA (912) Skilled Nursing Facility IHS at Savannah Beach Nursing & Rehabilitation Center 90 Van Horne Ave Tybee Island, GA (912) Riverview Health & Rehabilitation Center 6711 La Roche Ave Savannah, GA (912) Sleep Disorders SleepCare Institute, Inc 836 E 65th St Bldg 2 (912) The Sleep Disorders Center at St. Josephs Hospital Mercy Blvd Suiate 4 Savannah, GA (912) CHATTOOGA Dialysis Center Harbin Clinic Summerville Dialysis Center Highway 27 Summerville, GA (706) Rehabilitation Therapy Facility Advance Rehabilitation & Consulting, Inc Highway 27 Ste 1 Summerville, GA (706) CHEROKEE Ambulatory Surgery Center Woodstock Endoscopy Center, LLC 2001 Professional Way Ste 270 Woodstock, GA (404) Audiology Progressive Audiology Center, Inc Towne Lake Pkwy Bldg 800, (770) Convenience Care Clinic MinuteClinic Diagnostic of Georgia, LLC 1600 Towne Lake Pkwy (866) Sixes Rd (866) Hickory Flat Hwy Canton, GA (866) Diagnostic Facility Atlantic Diagnostic Center, LLC 720 Transit Ave Suite 201 (770) Dialysis Center FMC Dialysis Services Woodstock 100 Londonderry Ct Woodstock, GA (770) RCC Northern Georgia 411 Hospital Rd (770) Woodstock Dialysis 2001 Professional Pky Woodstock, GA (678) Durable Medical Equipment BioKinetics, Inc 3013 High Vista Walk (770) DJO, LLC 1131 Etowah Valley Ln (800) Physiotherapy Associates 720 Transit Ave ste 102 (678) SleepMed Incorporated 2230 Towne Lake Pkwy Bldg 1000 (770) Occupational Therapy Towne Lake Hand Therapy, Inc Towne Lake Pkwy Bldg. 600 Ste 110 (770) Physical Therapy Woodstock Physical Therapy & Joint Medicine, LLC 1816 Eagle Dr Bldg 100, (770) Physical, Speech, Occup Therapy BenchMark Physical Therapy 2230 Towne Lake Pkwy Bldg 1200, & 110 (770) Physiotherapy Associates 655 Molly Ln (770) Prosthetics/Orthotics DJO, LLC 1131 Etowah Valley Ln (800) Radiology Children's Radiology of Atlanta 2001 Professional Pky Ste 160 Woodstock, GA (770) Open Woodstock Imaging Center 2001 Professional Way Ste 160 Woodstock, GA (770) Quantum Radiology - Kennestone Towne Lake Imaging 120 Stonebridge Pkwy (678) Wellstar Kennestone Medical Imaging Center at Towne Lake 120 Stonebridge Pkwy (678) Woodstock Diagnostic Imaging 300 Parkbrooke Pl Ste 170 (678) Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 230 Marietta Hwy Ste 120 (770) Skilled Nursing Facility IHS at Woodstock Nursing & Rehabilitation Center 105 Arnold Mill Rd Woodstock, GA (770) Sleep Disorders SleepMed Incorporated 2230 Towne Lake Pkwy Bldg 1000 (770) CLARKE Ambulatory Surgery Center American Eye Surgery Center 651 S Milledge Ave Athens, GA (706) Georgia Lithotripsy & Laser Center 120 Trinity Pl Athens, GA (706) Dialysis Center Dialysis Center of Athens 210 Hawthorne Park (706) Gambro Healthcare-Athens West 2047 Prince Ave (706) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the web at 16

17 Ancillary Providers Clayton County Rehabilitation Therapy Facility RCG Clarke County 850 Prince Ave (706) Durable Medical Equipment Apria Healthcare, Inc Jefferson Rd Athens, GA (706) Fuller Rehabilition Independent Living Aids- Athens 3190 Atlanta Hwy Suite 15-A (706) Hanger Prosthetics & Orthotics East, Inc. 698 S Milledge Ave Athens, GA (800) Hanger Prosthetics & Orthotics, Inc Prince Ave (706) Home Medical Professional 191 Alps Rd ste 8 (706) Lincare, Inc 2440 W Broad St Ste 9 (706) Hospice Heartland Hospice Services 330 Research Dr Suite 130 Athens, GA (706) MRI Open MRI of Athens 845 Prince Ave (706) Physical Therapy East Athens Physical Therapy 665 Gaines School Rd Athens, GA (706) Horizon Physical Therapy and Rehabilitation, Inc Prince Ave (706) Physical, Speech, Occup Therapy Physiotherapy Associates 788 Prince Ave ste C (706) Prosthetics/Orthotics Apria Healthcare, Inc Jefferson Rd Athens, GA (706) Atlanta Prosthetics & Orthotics, Inc Hawthorne Ave Suite L (706) Hanger Prosthetics & Orthotics, Inc Prince Ave (706) Radiology Athens Diagnostic Center 1063 Baxter St (706) Open MRI of Athens 845 Prince Ave (706) Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 1000 Hawthorne Ave Ste J (706) Skilled Nursing Facility Guardian Home Care of Central Georgia, LLC 435 Hawthorne Ave (706) Speech/Hearing Therapy ABC Pediatric Therapy Partners, Inc 1175 Oglethorpe Ave (706) CLAYTON Alcohol/Chemical Dependency Riverwoods Psychiatric Center 11 Upper Riverdale Rd SW (770) Anchor Hospital 5454 Yorktowne Dr Atlanta, GA (770) Ambulance Lifestar Response dba Care Ambulance 277 Southfield Pkwy Forest Park, GA (404) Ambulatory Surgery Center G.I. Endoscopy Center 6555 Professional Pl (770) Surgery Center At Mt. Zion 4000 Corporate Center Dr Morrow, GA (770) Akstein Eye Center 86 Upper Riverdale Rd (770) Atlanta South Endoscopy Center 34 Upper Riverdale Road Suite 201 (678) Clayton Cataract and Laser Surgery Center 1000 Corporate Center Dr Ste 180 Morrow, GA (770) Southern Crescent Endoscopy Center 7402 Davidson Pkwy S (770) Ancillary Concentra Urgent Care 1368 Southlake Plaza Dr Morrow, GA (678) Moreland Ave Conley, GA (404) Clark Howell Hwy Atlanta, GA (404) Dialysis Renal Care Group Clayton County 335 Upper Riverdale Rd -1 Jonesboro, GA (770) Dialysis Center Forest Park Dialysis 380 Forest Pkwy Forest Park, GA (404) Jonesboro Dialysis 129 King St Jonesboro, GA (770) Renal Treatment Centers- Jonesboro Dialysis 129 King St Jonesboro, GA (770) Southern Crescent Dialysis Center 275 Upper Riverdale Rd SW (770) Durable Medical Equipment American Homecare Supply, Georgia, Inc 4820 Clark Howell Hwy -4 Atlanta, GA (404) Hanger Prosthetics & Orthotics, Inc. 155 Medical Way (770) SleepMed, Inc 217 Arrowhead Blvd 3 Jonesboro, GA (800) Home Health Agency Southern Regional Home Care 11 Upper Riverdale Rd SW (770) Hospice Embracing Hospice Care of South Atlanta LLC 315 Arrowhead Blvd Jonesboro, GA (678) In Home Health, Inc Lake Ridge Pkwy Riverdale, GA (770) Laboratory Quest Diagnostics - Riverdale 107 Upper Riverdale Rd SW (770) Quest Diagnostics-Riverdale 83 Upper Riverdale Rd Ste 120 (770) Physical Therapy Children's Healthcare of Atlanta at Mt. Zion 2201 Mount Zion Pkwy Morrow, GA (404) Excel Physical therapy 1883 McDonough Rd Bldg 200 Hampton, GA (678) Physical, Speech, Occup Therapy Morrow Physical Therapy 3000 Corporate Center Dr Ste 255 Morrow, GA (770) Physiotherapy Associates 1669 Phoenix Pkwy Ste 102 Atlanta, GA (770) Upper Riverdale Rd 10 Jonesboro, GA (770) Forest Pky Ste 14 Forest Park, GA (404) Rehab South Physical Therapy-Southside 150 Medical Way Ste E1 (770) Prosthetics/Orthotics Hanger Prosthetics & Orthotics, Inc. 155 Medical Way (770) Radiology Radiology Associates of Clayton 33 Upper Riverdale Rd SW Ste 105 (770) South Atlanta Radiology Associates, P.C. 119 Upper Riverdale Rd SW (770) Am-Med Medical Imaging 34 Upper Riverdale Road Suite 102 (770) Children's Radiology of Atlanta 237 Medical Way (770) Open MRI Centers of Georgia 6584 Professional Pl Suite D (770) Riverdale Radiology Center, LLC 237 Medical Way (770) Rehabilitation Therapy Facility Southern Regional Medical Center 11 Upper Riverdale Rd SW (770) Southern Regional Medical Center-Laboratory 11 Upper Riverdale Rd SW (770) Concentra Health Services 1368 Southlake Plaza Dr Morrow, GA (678) Moreland Ave Conley, GA (770) Clark Howell Hwy Atlanta, GA (404) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the web at 17

18 Ancillary Providers Clayton County Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 6319 A Jonesboro Rd Morrow, GA (770) HealthSouth Sports Medicine & Rehabilitation Ctr 275 Upper Riverdale Rd SW (770) Sleep Disorders Do You Snore, LLC 6555 Professional Pl (404) SleepMed, Inc 217 Arrowhead Blvd 3 Jonesboro, GA (800) The Sleep Disorders Centers of Southeastern Lung Care in South Atlanta 181 Upper Riverdale Rd SW Building A, Suite 2 (770) Speech/Hearing Therapy Children's Healthcare of Atlanta at Mt. Zion 2201 Mount Zion Pkwy Morrow, GA (404) COBB Alcohol/Chemical Dependency Ridgeview Institute 3995 S Cobb Dr SE Smyrna, GA (770) WellStar Windy Hill Hospital 2540 Windy Hill Rd SE Marietta, GA (770) Ambulatory Surgery Center Ambulatory Foot & Leg Surgical Center 1652 Mulkey Rd (770) Cobb Endoscopy Center, LLC 3969 S Cobb Dr SE Suite 207 Smyrna, GA (770) Cobb Foot & Leg Surgical Center 792 Church St Suite 401 (770) East West Surgery Center, LP 2041 Mesa Valley Way Ste 125 (678) GI Diagnostics Endoscopy Center, LLC 2550 Windy Hill Rd SE Ste 302 Marietta, GA (770) Marietta Eye Clinic DBA Marietta Eye Surgery 895 Canton Rd Bldg 200 Suite 300 (678) Marietta Surgical Center 780 Canton Rd (770) Northwest Georgia Orthopeadic Surgery Center 2550 Windy Hill Rd SE Ste 218 Marietta, GA (770) The Center for Spine Procedures, PC 335 Roselane St NW (770) Urology Associates Surgery Center, LLC 300 Tower Rd Suite 150 (678) Wellstar Kennestone Surgery Center-Outpatient 677 Church St (770) Westside Endoscopy Center 3825 Medical Park Dr (770) Ancillary Take Care Health Georgia, PC 5230 Dallas Hwy Powder Springs, GA (866) Audiology Children's Healthcare of Atlanta in Cobb 1371 Church Street Ext (770) Progressive Audiology Center, Inc 3960 Shallowford Rd Marietta, GA (770) Convenience Care Clinic MinuteClinic Diagnostic of Georgia, LLC 2014 Powers Ferry Rd SE Atlanta, GA (866) Atlanta Rd SE Smyrna, GA (866) N Main St NW Kennesaw, GA (866) Due West Rd NW Marietta, GA (866) Paces Ferry Rd SE Atlanta, GA (866) Take Care Health Georgia, PC 1762 Mars Hill Rd NW Acworth, GA (866) Roswell Rd Marietta, GA (866) Cobb Pkwy NW Kennesaw, GA (866) Shallowford Rd Marietta, GA (866) Austell Rd (866) Take Care Health Georiga, PC 2670 Cobb Pkwy SE Smyrna, GA (866) Diagnostic Facility A Diagnostic Radiology Network Facility 2501 Chastain Meadows Pkwy Marietta, GA (800) Atlantic Diagnostic Center, LLC 1620 Mulkey Rd (770) Cardiac CT Imaging Center at 55 Witcher Street 55 Whitcher St Suite 150 (678) Dialysis Center Bio-Medical Applications of South Cobb 3565 Austell Rd SW Ste 13 Marietta, GA (770) Cobb Nephrology Dialysis Center, Inc Medical Park Dr (770) Fresenius Medical Care of North Cobb 1392 Bells Ferry Rd Marietta, GA (770) RCC Marietta 1277 Kennestone Cir Ste 600 Marietta, GA (770) Renal Care Group Smyrna 2700 Highlands Pkwy SE Smyrna, GA (678) Durable Medical Equipment Access Homecare Services, Inc 2211 New Market Pkwy SE Ste 156 Marietta, GA (678) Advanced Home Medical 1395 S Marietta Pkwy SE Bldg 100, Ste 106 Marietta, GA (770) American Homecare Supply, Georgia, Inc 2010 Cobb International Blvd NW Ste D Kennesaw, GA (770) Apria Healthcare, Inc New Market Pkwy SE Ste 156 Marietta, GA (770) Byram Healthcare 220 Cobb Pkwy N Marietta, GA (877) C.H. Martin 472 N Sessions St NW (770) DJO, LLC 707 WHITLOCK AVE STE F3 Marietta, GA (800) Dynamic Orthotics & Prosthetics, Inc The Exchange SE Suite 375 Atlanta, GA (770) Hanger Prosthetics & Orthotics, Inc. 124 Powers Ferry Rd SE Marietta, GA (770) Healthfield Inc 1395 S Marietta Pkwy SE Ste 910 Marietta, GA (770) Hi-Tech Healthcare, Inc 718 Cherokee St (770) Lincare, Inc 4451 Atlanta Rd SE Ste 106 Smyrna, GA (770) Pediatric Services of America, Inc 2217 Roswell Rd 100 Marietta, GA (770) Physiotherapy 4579 S Cobb Dr SE ste 100 Smyrna, GA (770) Source One Medical, Inc 2121 New Market Pkwy SE Suite 108 Marietta, GA (770) Vision Quest Industries, Inc Lake Acworth Dr Acworth, GA (800) Wellstar Home Medical Equipment 805 Sandy Plains Rd Marietta, GA (770) Emergency Department Wellstar Cobb Hospital 3950 Austell Rd (770) Home Health Agency Coram Alternate Site Services, Inc New Market Pkwy SE Suite 106 Marietta, GA (770) Healthfield Home Health Inc 1395 S Marietta Pkwy SE Ste 910 Marietta, GA (770) Matria Healthcare, Inc 1850 Parkway Pl SE Marietta, GA (770) Pediatric Services of America, Inc 2217 Roswell Rd 100 Marietta, GA (770) The Healthfield Group, Inc Riverwood Pkwy SE Suite 1400 Atlanta, GA (770) Wellstar Home Health 805 Sandy Plains Rd Marietta, GA (770) Wellstar Private Homecare Services 805 Sandy Plains Rd Marietta, GA (770) Home IV Infusion Agency Lacey's Vital Care 790 Church St ste 170 (770) Pediatric Services of America, Inc 2217 Roswell Rd 100 Marietta, GA (770) Premier Healthcare Solutions, LLC 4451 Atlanta Rd SE Ste 136 Smyrna, GA (770) Hospice Healthfield Hospice Services Inc 1395 S Marietta Pkwy SE Ste 902 Marietta, GA (770) Heritage Hospice, Inc Kennestone Cir 213 Marietta, GA (770) Wellstar Community Hospice 4040 Hospital West Dr (770) Laboratory Quest Diagnostics - Marietta 790 Church Street Ext (770) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the web at 18