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HB 789 Surprise Bill Transparency Act Information

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HB 789 Surprise Bill Transparency Act Information HB 789 Surprise Bill Transparency Act Information As part of the HB 789 Surprise Bill Transparency Act, Ambetter from Peach State Health Plan is providing consumers with the surprise bill rating for in-network hospital specialty groups. If a surprise bill rating is less than four checkmarks, each insurer advertising a hospital as in-network shall describe which qualified hospital based specialty group types are not contracted with the insurer. Please use the legend below to determine the rating for in-hospital specialty groups. Key Service Provided by In-Network Provider Service Provided by Out of Network Provider Service not offered at Facility Specialty Network Participation in Review To view a full listing of our in-network provider’s visit: https://guide.ambetterhealth.com/ NOTE: The information in this document was accurate when published. Since then, changes may have occurred that affect the information. Please call Member Services at 1-877-687-1180 or TTY/TDD 1-877-941-9231 for the most current provider information. 10/2020 This document is current as of the date listed below. A provider’s listing in the directory does not guarantee that the provider is still in the network or accepting new members. Ambetter from Peach State Health Plan 10/2020 TABLE OF CONTENTS / TABLA DE CONTENIDOS Page / Página Hospitals / Hospitales .......................................................................... 2 Index / Índice ........................................................................................ 6 Peach State Health Plan November/2020 1 Hospitals / Hospitales Appling County Appling County Coliseum Northside Camden County St. Joseph’s Hospital Cobb County Hospital 11705 Mercy Boulevard Appling Healthcare System 400 Charter Boulevard Southeast Georgia Health Savannah, GA 31419 Wellstar Cobb Hospital 163 E Tollison Street Macon, GA 31210 Systems Camden Phone: 912-819-4100 3950 Austell Road Baxley, GA 31513 Phone: 478-757-8200 Campus The rating for in-hospital Austell, GA 30106 Phone: 912-367-9841 The rating for in-hospital 2000 Dan Proctor Drive specialty groups Phone: 470-732-4000 The rating for in-hospital specialty groups Saint Marys, GA 31558 Anesthesia: The rating for in-hospital specialty groups Anesthesia: Phone: 912-576-6200 Emergency Medicine: specialty groups Anesthesia: Emergency Medicine: The rating for in-hospital Pathology: Anesthesia: Emergency Medicine: Pathology: specialty groups Radiology: Emergency Medicine: Pathology: Radiology: Anesthesia: Pathology: Radiology: Emergency Medicine: Cherokee County Radiology: Bleckley County Pathology: Bacon County Radiology: Northside Hospital Wellstar Windy Hill Hospital Bleckley Memorial Hospital Cherokee 2540 Windy Hill Road Bacon County Hospital 145 E Peacock Street 450 Northside Cherokee Marietta, GA 30067 302 South Wayne Street Candler County Cochran, GA 31014 Boulevard Phone: 770-644-1000 Alma, GA 31510 Phone: 478-271-6537 Candler County Hospital Canton, GA 30115 Phone: 912-632-8961 400 Cedar Street Phone: 770-224-1000 The rating for in-hospital The rating for in-hospital specialty groups The rating for in-hospital Metter, GA 30439 specialty groups The rating for in-hospital Anesthesia: specialty groups Phone: 912-685-5741 Anesthesia: specialty groups Emergency Medicine: Anesthesia: The rating for in-hospital Emergency Medicine: Anesthesia: Pathology: Emergency Medicine: specialty groups Pathology: Emergency Medicine: Radiology: Pathology: Radiology: Anesthesia: Pathology: Radiology: Emergency Medicine: Radiology: Coffee County Brooks County Pathology: Bartow County Radiology: Clarke County Coffee Regional Medical Brooks County Hospital Center Cartersville Medical Center 903 N Court Street Piedmont Athens Regional 1101 Ocilla Road 960 Joe Frank Harris Catoosa County Quitman, GA 31643 Medical Center Douglas, GA 31533 Parkway Southeast CHI Memorial Hospital Phone: 229-263-4171 1199 Prince Avenue Phone: 912-384-1900 Cartersville, GA 30120 The rating for in-hospital Georgia Athens, GA 30606 Phone: 770-382-1530 100 Gross Crescent Circle Phone: 706-549-9977 The rating for in-hospital specialty groups specialty groups The rating for in-hospital Ft Oglethorpe, GA 30742 Anesthesia: The rating for in-hospital Anesthesia: specialty groups Phone: 706-858-2161 Emergency Medicine: specialty groups Emergency Medicine: Anesthesia: The rating for in-hospital Pathology: Anesthesia: Pathology: Emergency Medicine: specialty groups Radiology: Emergency Medicine: Radiology: Pathology: Anesthesia: Pathology: Radiology: Burke County Emergency Medicine: Radiology: Pathology: Coweta County Burke Medical Center Ben Hill County Radiology: St Marys Hospital Piedmont Newnan Hospital 351 South Liberty Street 1230 Baxter Street Inc Dorminey Medical Center Waynesboro, GA 30830 Chatham County Athens, GA 30606 745 Poplar Road 200 Perry House Rd Phone: 706-554-4435 Phone: 706-389-3000 Newnan, GA 30265 Fitzgerald, GA 31750 The rating for in-hospital Memorial University The rating for in-hospital Phone: 770-254-3615 Phone: 229-424-7100 specialty groups Medical Center specialty groups The rating for in-hospital The rating for in-hospital Anesthesia: 4700 Waters Avenue Anesthesia: specialty groups specialty groups Emergency Medicine: Savannah, GA 31404 Emergency Medicine: Anesthesia: Anesthesia: Pathology: Phone: 912-819-6000 Pathology: Emergency Medicine: Emergency Medicine: Radiology: The rating for in-hospital Radiology: Pathology: Pathology: specialty groups Radiology: Radiology: Butts County Anesthesia: Emergency Medicine: Clayton County Wellstar Sylvan Grove Crisp County Berrien County Pathology: Southern Regional Medical Hosptial Radiology: Center Crisp Regional Hospital SGMC Berrien Campus 1050 McDonough Road 11 Upper Riverdale Road 902 North 7th Street 1221 E McPherson Avenue Jackson, GA 30233 St Joseph’s Candler Southwest Cordele, GA 31015 Nashville, GA 31639 Phone: 770-775-7861 Hospital Riverdale, GA 30274 Phone: 229-276-3100 Phone: 229-433-1000 The rating for in-hospital 5353 Reynolds Street Phone: 770-991-8000 The rating for in-hospital The rating for in-hospital specialty groups Savannah, GA 31405 The rating for in-hospital specialty groups specialty groups Anesthesia: Phone: 912-819-6000 specialty groups Anesthesia: Anesthesia: Emergency Medicine: The rating for in-hospital Anesthesia: Emergency Medicine: Emergency Medicine: Pathology: specialty groups Emergency Medicine: Pathology: Pathology: Radiology: Anesthesia: Pathology: Radiology: Radiology: Emergency Medicine: Radiology: Pathology: Decatur County Bibb County Radiology: Clinch County Memorial And Manor Coliseum Medical Center Clinch Memorial Hos Hospital Of Bainbridge 350 Hospital Drive 1050 Valdosta Highway 1500 E Shotwell Street Macon, GA 31217 Homerville, GA 31634 Bainbridge, GA 39819 Phone: 478-765-7000 Phone: 912-487-5211 Phone: 229-246-3500 The rating for in-hospital The rating for in-hospital The rating for in-hospital specialty groups specialty groups specialty groups Anesthesia: Anesthesia: Anesthesia: Emergency Medicine: Emergency Medicine: Emergency Medicine: Pathology: Pathology: Pathology: Radiology: Radiology: Radiology: 2 Hospitals / Hospitales Dekalb County Dekalb County Dougherty Emanuel County Franklin County WellStar Atlanta Medical Center Emory Decatur Hospital County Emanuel Medical Center St Marys Sacred Heart 303 Parkway Drive NE 2701 North Decatur Road 117 Kite Road Hospital Atlanta, GA 30312 Phoebe Putney Memorial Decatur, GA 30033 Swainsboro, GA 30401 367 Clear Creek Parkway Phone: 404-265-4301 Hospital Phone: 404-501-1000 Phone: 478-289-1100 Lavonia, GA 30553 2000 Palmyra Road The rating for in-hospital Phone: 706-356-7800 The rating for in-hospital Albany, GA 31701 The rating for in-hospital specialty groups specialty groups Phone: 229-434-2000 specialty groups The rating for in-hospital Anesthesia: Anesthesia: Anesthesia: specialty groups Emergency Medicine: The rating for in-hospital Emergency Medicine: Emergency Medicine: Anesthesia: Pathology: specialty groups Pathology: Pathology: Emergency Medicine: Radiology: Anesthesia: Radiology: Radiology: Pathology: Emergency Medicine: Radiology: Pathology: WellStar Atlanta Medical Emory Hillandale Hospital Radiology: Evans County Center South 2801 Dekalb Parkway 1170 Cleveland Avenue Evans Memorial Hosp Inc Fulton County Lithonia, GA 30058 417 West Third Avenue East Point, GA 30344 200 N River Street Emory Johns Creek Phone: 404-501-8000 Albany, GA 31701 Phone: 404-466-1170 Claxton, GA 30417 Hospital Phone: 229-312-1000 The rating for in-hospital Phone: 912-739-5055 6325 Hospital Parkway The rating for in-hospital specialty groups The rating for in-hospital specialty groups The rating for in-hospital Johns Creek, GA 30097 Anesthesia: specialty groups Anesthesia: specialty groups Phone: 678-474-7000 Emergency Medicine: Anesthesia: Emergency Medicine: Anesthesia: The rating for in-hospital Pathology: Emergency Medicine: Pathology: Emergency Medicine: specialty groups Radiology: Pathology: Radiology: Pathology: Anesthesia: Radiology: Radiology: Emergency Medicine: Emory University Hospital Pathology: WellStar North Fulton 1364 Clifton Road NE Early County Radiology: Hospital Atlanta, GA 30322 Fannin County 3000 Hospital Boulevard Lifebrite Community Phone: 404-712-7100 Fannin Regional Hospital Roswell, GA 30076 Hospital of Early Emory Midtown University 2855 Old Highway 5 North Phone: 770-751-2500 The rating for in-hospital 11740 Columbia Street Hospital Blue Ridge, GA 30513 specialty groups Blakely, GA 39823 550 Peachtree Street NE The rating for in-hospital
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