financial assistance policy provider appendix...financial assistance policy provider appendix...

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Financial Assistance Policy Provider Appendix Updated in October 2018 The following Piedmont practices are covered under Piedmont Healthcare’s Financial Assistance Policy: ARMC Anesthesia Department Piedmont Cancer Institute ARMC Community Care Clinic Piedmont Cardiology of Atlanta, LLC ARMC Hospitalist Group Piedmont Emergency Medicine ARMC Midwifery Clinic Piedmont Healthcare Inc ARMC Neonatal Intensive Care Piedmont Heart ARMC Pathology Associates Piedmont Heart ARMC Psychiatry Piedmont Hospitalist Physicians ARMC Surgicalists Group Piedmont Hospitalist Physicians, LLC ARMC Wound Care Piedmont Medical Care Corporation Athens Cardiology Group Piedmont Pediatric Physicians, LLC Athens Regional Physician Services Piedmont Physicians Breast Surgery Athens Regional Specialty Services Piedmont Physicians Cardiology Athens Regional Specialty Services Piedmont Physicians Endocrinology Columbus Regional OB/GYN I Piedmont Physicians ENT I Columbus Regional OB/GYN II Piedmont Physicians Gastroenterology Columbus Regional Pediatric Neurology Piedmont Physicians General Surgery Columbus Regional Pediatrics Piedmont Physicians Gynecologic Oncology CRMG Breast and Thoracic Surgery Piedmont Physicians Heart Failure CRMG Chattahooche Valley Family Physicians Piedmont Physicians Heart Failure CRMG Critical Care Piedmont Physicians Infectious Disease Walton CRMG Endocrine Consultants Piedmont Physicians Intensivists CRMG Family Physicians of Columbus Piedmont Physicians Neuro Oncology CRMG Gastroenterology Piedmont Physicians Neuro Surgery CRMG NewBorn Practitioners Piedmont Physicians Neurology CRMG Pulmonary Piedmont Physicians OBGYN CRMG Roman Primary Care Piedmont Physicians Orthopedics and Sports Medicine CRMG Surgical Associates Piedmont Physicians Palliative Care CRMG Urogynecology and OB/GYN Piedmont Physicians Pediatrics CRMG Winship Family Medicine Piedmont Physicians Primary Care Maternal Fetal Medicine Piedmont Physicians Rheumatology Piedmont Athens Cardiothoracic Surgery Piedmont Physicians Surgical Oncology Piedmont Athens Hospitalist Physicians Piedmont Physicians Surgicalists Piedmont Athens Physicians Adult and Pediatric Medicine Piedmont Physicians Urology

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Page 1: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

The following Piedmont practices are covered under Piedmont Healthcare’s

Financial Assistance Policy:

ARMC Anesthesia Department

Piedmont Cancer Institute

ARMC Community Care Clinic

Piedmont Cardiology of Atlanta, LLC

ARMC Hospitalist Group

Piedmont Emergency Medicine

ARMC Midwifery Clinic

Piedmont Healthcare Inc

ARMC Neonatal Intensive Care

Piedmont Heart

ARMC Pathology Associates

Piedmont Heart

ARMC Psychiatry

Piedmont Hospitalist Physicians

ARMC Surgicalists Group

Piedmont Hospitalist Physicians, LLC

ARMC Wound Care

Piedmont Medical Care Corporation

Athens Cardiology Group

Piedmont Pediatric Physicians, LLC

Athens Regional Physician Services

Piedmont Physicians Breast Surgery

Athens Regional Specialty Services

Piedmont Physicians Cardiology

Athens Regional Specialty Services

Piedmont Physicians Endocrinology

Columbus Regional OB/GYN I

Piedmont Physicians ENT I

Columbus Regional OB/GYN II

Piedmont Physicians Gastroenterology

Columbus Regional Pediatric Neurology

Piedmont Physicians General Surgery

Columbus Regional Pediatrics

Piedmont Physicians Gynecologic Oncology

CRMG Breast and Thoracic Surgery

Piedmont Physicians Heart Failure

CRMG Chattahooche Valley Family Physicians

Piedmont Physicians Heart Failure

CRMG Critical Care

Piedmont Physicians Infectious Disease Walton

CRMG Endocrine Consultants

Piedmont Physicians Intensivists

CRMG Family Physicians of Columbus

Piedmont Physicians Neuro Oncology

CRMG Gastroenterology

Piedmont Physicians Neuro Surgery

CRMG NewBorn Practitioners

Piedmont Physicians Neurology

CRMG Pulmonary

Piedmont Physicians OBGYN

CRMG Roman Primary Care

Piedmont Physicians Orthopedics and Sports Medicine

CRMG Surgical Associates

Piedmont Physicians Palliative Care

CRMG Urogynecology and OB/GYN

Piedmont Physicians Pediatrics

CRMG Winship Family Medicine

Piedmont Physicians Primary Care

Maternal Fetal Medicine

Piedmont Physicians Rheumatology

Piedmont Athens Cardiothoracic Surgery

Piedmont Physicians Surgical Oncology

Piedmont Athens Hospitalist Physicians

Piedmont Physicians Surgicalists

Piedmont Athens Physicians Adult and Pediatric Medicine

Piedmont Physicians Urology

Page 2: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Piedmont Athens Physicians Endocrinology

Piedmont Physicians Wound Care

Piedmont Athens Physicians Gynecology

Piedmont Professional Services

Piedmont Athens Physicians Heart

Piedmont Providers LLC

Piedmont Athens Physicians Midwifery

Piedmont Pulmonary, Critical Care & Sleep Medicine

Piedmont Athens Physicians Neurosurgery

Piedmont QuickCare

Piedmont Athens Physicians Orthopedics and Sports Medicine

Piedmont QuickCare Athens

Piedmont Athens Physicians Pediatric Infectious Disease

Piedmont Transplant Infectious Disease

Piedmont Athens Physicians Pediatrics

Piedmont Transplant Institute

Piedmont Athens Physicians Primary Care

PMCC: Piedmont Medical Care Corporation

Piedmont Athens Physicians Psychiatry

Regional First Care

Piedmont Athens Physicians Surgery

Rockdale General Surgery

Piedmont Athens Urgent Care

Page 3: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

The following is a list of practices rendering care at Piedmont Healthcare hospitals

and facilities not covered under Piedmont Healthcare’s Financial Assistance

Policy:

24 ON Physicians PC

Jennifer Wells DMD

A Keith Martin MD

John A Drummond MD

Absolute Care

John David Mullins, MD, PC

Absolute Care, Inc

John F. Elder, MD PC

Acadia Riverwoods Behavioral Health

John M. Griffin, M.D.

Accurate Neuromonitoring SE, LLC

John M. Potts, MD

Achilles Foot & Ankle Specialists

Johnson & Murthy Family Practice

AcuteCare Telemedicine

Jonesboro Pediatrics

Adams Primary Care. PC

Jorge Amador MD

Advanced Aesthetics, P.C.

Joseph H Martin Jr MD LLC

Advanced Internal Medicine

Joseph M. Woods, LLC

Advanced Laparoscopic Surgical

Juan Mannings CSA

Advanced Radiology Services

Juliet Asher MD

Advanced Spine and Pain Interventions

Just Breast

Aesthetic and Reconstructive Surgery

Kala K Cunard MD

Affiliated Foot & Ankle, P.C.

Kalos Plastic and Reconstructive Surgery

Affiliated Foot and Ankle, P. C.

Kamlesh D. Nayak, MD, PC

AGA Clinical Services

KAO

Ahmed Family Practice

Kathy C Lynn MD

AID Atlanta

Kaushik Amin MD

Akstein Eye Center, PC

Keller Crymes and DeMarco LLC

Alan D Glassman MD

Kelvin M Hamner

Alcovy Gastroenterology Associates

Kennestone Cardiovascular Consultants

Alcovy Internal Medicine

Kennestone Internal Medicine Assoc., PC

Alcovy Neurology

Kevin Kurey, MD

Alex E Rikhter MD PC

Khair Family Practice

All For Kids Dental Group LLC

Kidney & Hypertension Center

All Starr Pediatrics

Kidney Clinc

Allcare GA

Kidney Clinic of Athens

Allergy and Asthma Specialists

Kidney Hypertension Clinic

Allergy Sinus and Cough Center of Georgia

L & H Internal Medicine

Allergy, Asthma & Arthritis Center of Athens

L. Raul Takagi, MD, F.AC.O.G

Alliance Family Care, LLC

LaGrange Internal Medicine

Alliance Spine and Pain Center

Landmark Hospital Athens

Alpha Internal Medicine LLC

Laureate Medical Group

Alpha Medical Centre

Lawrence Kirk Jr MD LLC

Page 4: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Amanu Physical Medicine and Rehabilitation, LLC

Lawrence R Gross MD

American Anesthesiology

Lee John Skandalakis MD

American Family Care

Lencia Technology, LLC

American Foot & Leg Specialists

Leslie M Pitts, DMD Pediatric Denistry

Anderson Center for Hair

Lexington Plastic Surgeons

Andrew H. Abernathy, III, M.D.

Life Boat Medical Associates

Anesthesia Associates Of Gainesville

Lifetime Medical Center

Angela Vela, M.D.

Lillette A Intaphan MD

Anglyn Family Medical Center

Linda Britton, MD, PC

Ankle & Foot Clinic of Georgia, Inc.

Lisa D Miller MD Pediatrics PC

Ankle and Foot Centers

LiveOn One LLC

Ankle and Foot Centers of Georgia

Locum Leaders

Anthony Allen, PA-C

Locust Grove Pediatrics, LLC

Arati Pandya MD

Loganville Family Medicine

Aris/ US Teleradiology

Long H Le MD

Arslanian Plastic Surgery

Lotus Surgical Assistants, Inc.

Arthritis & Rheumatology Clinic, LLC

Lowance Group

Arthritis Center of NE Georgia

Lung Care Specialist of Georgia

Arthritis Research & Treatment Center

M. Lyubich, MD, PC

Ascend Pediatric Neurology

Macon Surgical Associates

Ashford Ear Clinic

Manning Pediatrics, LLC

Aspen Dental

Maria Cavaliere

Associated Foot and Ankle Specialists

Marietta Eye Clinic, P.A.

Atex Assisted Recovery of Athens

Mark Codner MD Plastic Surgery

Athens Adult & Pediatric Medicine

MasterCare Medical Center

Athens Area Pediatric Denistry

Matthew W Camp Ophthalmology

Athens Area Pediatrics

Matthew W. Camp Ophthalmology, LLC

Athens Area Surgical Associates

MCC Internal Medicine

Athens Area Urology

McDaniel and Durrett

Athens Bone & Joint

McDonough Adult and Pediatric Care

Athens Brain & Spine

McDonough Adult and Pediatric Medical Care

Athens Cardiac Clinic

McDonough General Surgery

Athens Cardiovascular & Thoracic Surgery

McDonough Pediatrics, PC

Athens Children's Clinic

McDonough Primary Care

Athens Denistry for Children

McIntosh Trail Family Practice

Athens Diabetes and Endocrinology

McRae Family Dental, P.C.

Athens Eye Associates

McSwain,Cook,Ingvoldstad,Schapiro & Dozier, MD,PC

Athens Eye Doctors & Surgeons

MD On Call, Inc.

Page 5: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Athens Gastroenterology

MD Pain Care

Athens General & Colorectal Surgeons

MDVIP Medical Group

Athens Geriatrics & Internal Medicine

Med Fast Medical Clinic

Athens Healthcare for Women

Med South Primary Care

Athens Heart Center

MedCare

Athens Internal Medicine Associates

Medical Care of Georgia, PC

Athens Kidney Center

Medical Center

Athens Kids Specialists

Medical Center Anesthesiology of Athens

Athens Maternal-Fetal Medicine, PC

Medical Dermatology Specialists

Athens Medical Associates

Medical Doctor Associates

Athens Medical Clinic & Sleep Medicine Associates

Medical Healthcare

Athens Neighborhood Health Center

MedLink Georgia

Athens Neurological Associates

Mercy Health Center

Athens Neurological Associates PC

Meridian Internal Medicine and Primary Care

Athens OBGYN II

Meridian Surgical

Athens Obstetrics and Gynecology

Metro Atlanta Surgical Assistants, LLC

Athens Oral & Maxillo-Facial Surgery, PC

Metro Foot & Ankle Centers

Athens Oral Surgery Center

Metro Infectious Disease Consultants, LLC

Athens Orthopedic Associates

Metro Nephrology

Athens Orthopedic Clinic

Metropolitan Atlanta Cardiology Consult

Athens Pediatrics at Resource Medical

Michael B. Stubbs, M.D.

Athens Plastic Surgery Center

Michael E Nelson MD

Athens Podiatry, PC

Michael J. Grundy, MD, PC

Athens Pulmonary & Sleep Medicine PC

Michael S. Landy, MD, PA

Athens Pulmonary and Critical Care Medicine, PC

Michael Todd Peacock

Athens Pulmonary and Sleep Medicine

Michael V. Robertson, M.D.

Athens Radiology Associates PC

Michael W Johnston

Athens Regional Pathology Associates

Middle Georgia Chest and Medical Center

Athens Regional Physician Service - Martin & Martin

Middle Tennessee Neurology

Athens Retina Center

Midtown Family Medicine

Athens Rheumatology Clinic

Midtown Medical Center Transitional Clinic

Athens Spine Center

Midtown Neurology

Athens Surgical Group

Miles Family Medicine, LLC

Athens Womens Clinic

Millennium Physician Group

Athens Women's Clinic

Milstead Pathology PC

ATL Colorectal Surgery

Milton Hall Surgical Associates

ATL Colorectal Surgery, PC

Mini Smiles Pediatric Dentistry

Atlanta Allergy & Asthma, PA

Minimally Invasive Surgical Institute

Atlanta Allergy and Otolaryngology Center LLC

Modern Dermatology Atlanta

Page 6: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Atlanta Bone and Joint Specialists

Mohammed Obeidin MD

Atlanta Brain and Spine Care

Montgomery Medical Associates

Atlanta Breast Cancer PC

Morehouse Healthcare

Atlanta Breast Care

Morehouse School of Medicine

Atlanta Cancer Care

Mostafa Niknafs DPM

Atlanta Cardic & Thoracic Surgery Assoc.

Mountainside Anesthesia Consultants

Atlanta Center for ENT and Facial Plastic

Mountainside Pediatrics, LLC

Atlanta Children's Center

My Kidz Dentist

Atlanta Clinical Research Centers

My OB/GYN, PC

Atlanta Colorectal Surgery PC

My Pain Clinic

Atlanta Dermatologic Surgery Consultants

MyCare Blackmon Road

Atlanta Dermatology & Aesthetics

MyCare Urgent Care and Occuptional Medicine

Atlanta Dermatology and Aesthetics, PC

N Hadley Heindell III MD

Atlanta Diabetes Associates

Nadolne Family Medicine and Preventive Care

Atlanta Eye Consultants, P.C

Nathan H Schwartz DPM PC

Atlanta Foot & Leg Clinics

Nd Ndukwe, MD

Atlanta Gastroenterology Associates LLC

NE Georgia Anesthesia Services Inc

Atlanta Heart Associates

Nephrology

Atlanta Heart Associates, PC

Nephrology and Hypertension Specialists of GA

Atlanta Heart Associates, PC - Vascular

Nephrology Consultants of Georgia

Atlanta ID Group

NeuroCare Center of Atlanta

Atlanta Kidney Specialists

Neurology Associates

Atlanta Lung Specialists

Neurology South

Atlanta Maternal Fetal Medicine

Neurology South PC

Atlanta Medical Associates

Neuropsychiatric Consultants, LLC

Atlanta Medicine & Cardiology Ctr., P.C.

New Beginnings Comprehensive Womens Healthcare

Atlanta Minimally Invasive Surgical Center

Newfield Orthopedics

Atlanta Nephrology Referral Center, LLC

Newnan Dermatology

Atlanta Neurological Associates

Newnan Neurology

Atlanta Neurological Institute, PC

Newnan Pediatrics Jefferson Parkway

Atlanta North Dermatology and Skin Care

Nexclin Medicine

Atlanta OB/GYN Associates

Nicholas A. Pietrzak

Atlanta OBGYN Associates / Peachtree Women's Specialists

Nitin R Desai MD

Atlanta Orthopaedic Institute

Nizar A. Tejani, MD, PC

Atlanta Orthopedic & Arthroscopy Center,

North Atlanta Heart & Vascular Center

Atlanta Perinatal Associates

North Atlanta Medical Associates

Atlanta Perinatal Consultants LLP

North Atlanta Nephrology

Page 7: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Atlanta Plastic and Reconstructive Specialist

North Atlanta Primary Care

Atlanta Plastic and Reconstructive Surgery

North Atlanta Surgical Associates

Atlanta Plastic Surgeons

North Broad Medical Office

Atlanta Plastic Surgery

North Fulton Internal Medicine Group

Atlanta Plastic Surgery Specialists

North Georgia Foot and Ankle Clinic

Atlanta Plastic Surgery, PA

North Georgia Nephrology Consultants

Atlanta Psychiatry and Neurology, PC

North Georgia Primary Care

Atlanta Pulmonary Associates

North Georgia Pulmonary Medicine

Atlanta Pulmonary Care and Sleep Solutions

North Metropolitan Radiology Associates

Atlanta Retina

North Roswell Internal Medicine

Atlanta Skin Cancer Specialists

Northeast Cardiology PC

Atlanta South Nephrology

Northeast GA Anesthesia Services, Inc

Atlanta Spine

Northeast Georgia ENT Head/Neck Surgery

Atlanta Spine Clinic

Northeast Georgia Physicians Group

Atlanta Sports Medicine and Orthopedic Center

Northeast Georgia Surgical Consultants

Atlanta Surgery Associates

Northeast Georgia Surgical Healthcare

Atlanta Urological Group, MD

Northside Allergy, Asthma & Internal Med

Atlanta Urological Institute, LLC

Northside Family Medicine

Atlanta Vascular Specialists

Northwest ENT Associates

Atlanta Vascular Specialists

Northwest Georgia Oncology Centers, PC

Atlanta Vision Institute

Northwest Georgia Surgical Specialists

Atlanta Womens Health Group

Northwest Medical Center

Atlanta Womens Healthcare Specialists

Northwest Neurosurgical Associates, PC

Atlanta Womens Healthcare Specialists Lab

Nuvasive Clinical Services

Atlanta Women's OB/GYN

Oakhurst Medical Centers, Inc.

Atlanta Womens Obstetrics and Gynecology

OBGYN Specialists, LLP

Atlantic Cod Emergency Physicians

Ocmulgee Physicians

Babcock Dermatology

Oconee Heart & Vascular Center

Barbara L. Fields, M.D., P.C.

Oconee Medical Group

Barnett and Powers

Oconee Nephrology Associates

Bassam Tome MD

Oconee Primary Care

Beltline Bariatric and Surgical Group

Olansky Dermatology Associates

Bethlehem Family Healthcare

OMNI Primary Care

Beverly B Sanders MD

Ophthalmic Plastic and Cosmetic Surgery

Bhavin Jani, MD

Optimal Performance Medicine

Biologic Behavioral

Optimum Foot and Ankle Centers

Blue Ridge MTN Internal Medicine

Oral Surgery Associates

Boddie Medical

Oral Surgery Associates & Dental Implant Center

Bolanle Sogade MD LLC

O'Reilly Comprehensive Dermatology

Page 8: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Boulevard Family Practice

Organ Transplant Services

Brad Hall, DMD

Ortho Sport and Spine Physicians LLC

Bradley G Jacoby MD

OrthoAtlanta

Brain Expert

Orthopedic Solutions

Briavista Pediatrics

Orthopedics and Sports Medicine Newton

Bruce Beeber, M.D.

Our Family Health Center

Buckhead Breast Care

Paces Ferry Medical Group

Buckhead Concierge Internal Medicine

Pain & Palliative Care Center of Atlanta

Buckhead Dermatology

Pain Care

Buckhead ENT

Pain Consultants of Atlanta

Buckhead Facial Plastic Surgery

Pain Management Specialist of Atlanta

Buckhead Internal Medicine

Palghat Mohan MD

Buckhead Plastic Surgery

Panacea Plastic Surgery

Buckhead Sports Medicine

PAR Emergency Department

Burson ENT, LLC

Parker Plastic Surgery

Byron F Harper III MD

Patricia A Lloyd MD

C & C Neurological Associates, PLLC

Peach State Nephrology

Caedel Medical Group

Peachford Behavioral Health System

Cairo Medical Care

Peachstate Family Clinic

Cardiac Disease Specialists, PC

Peachtree Allergy and Asthma Clinic

Cardiology Consultants of Atlanta, PC

Peachtree Cardiovascular & Thoracic Surgeons, PA

Cardiology of Georgia

Peachtree City Obstetrics and Gynecology

Cardiovascular Group

Peachtree City Physicians Group

Caritas Medical Center, LLC

Peachtree Dermatology

Carol M Odegaard MD

Peachtree Dermatology Associates

Carr Medical Group, PC

Peachtree Dunwoody Dermatology

Centennial Neuroscience

Peachtree Dunwoody Oral and Facial Surgery

Center for Allergy and Asthma of Georgia

Peachtree Emergency Associates, P.C.

Center For Foot and Ankle Care

Peachtree Fayette Women's Specialist

Center for Integrated Healing, Inc.

Peachtree Gynecology

Center for Sight

Peachtree Internal Medicine

Center for Specialty Eye Care

Peachtree Kidney and Hypertension Specialist

Center of Hope for Cancer & Blood

Peachtree Laboratory Associates

Central Georgia Pulmonary Associates

Peachtree Maxillofacial Surgery

Cherokee Family Medical Center

Peachtree Medical Center PC

Chhokar Clinic

Peachtree Nephrology

ChiChi Berhane MD

Peachtree Neurological Clinic

Children's Cardiology Services

Peachtree Neurosurgery

Children's Cardiovascular Medicine

Peachtree Orthopedic Clinic

Page 9: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Childrens Care Pediatrics

Peachtree Park Pediatrics, LLP

Children's Care Pediatrics

Peachtree Pediatrics

Children's Center for Digestive Healthcare

Peachtree Piedmont Associates, PC

Children's Heart Specialists of Georgia, PC

Peachtree Piedmont Pathology

Children's Orthopaedics of Atlanta

Peachtree Plastic Surgery

Children's Pediatrics Centers, Northside

Peachtree Radiation Oncology

Childrens Physician Group Pediatric Surgery

Peachtree Spine and Pain Physicians Inc

Children's Physician Group Pulmonary at Scottish Rite

Peachtree Sports Medicine, P.C.

Children's Surgery LLC

Peachtree Surgical and Bariatrics

Childrens Surgical Associates

Peachtree Vascular Associates, PC

Children's Surgical Associates PC

Peachtree Women's Specialists

Chris E Malone, MD

Pearls of Health

Christ the King Medical Centetr

Pediatric Adolescent Surgical Associates

Ciao Bella Medical Center and Spa

Pediatric Anesthesia Specialists

CJ Pediatrics, LLC

Pediatric Associates of Newnan, PC

Clarke Oconee Family Practice LLC

Pediatric Cardiology Services PC

Clayton Orthopedic Clinic

Pediatric Center for Wellness

Clearview Ear, Nose and Throat Specialists

Pediatric Ear, Nose & Throat of Atlanta

Clearview Infectious Disease

Pediatric Emergency Medicine Associates

Clearview Primary Care at Breedlove

Pediatric Eye Consultants of Atlanta

Clearview Primary Care at Grayson

Pediatric Health Care of Conyers

Clearview Primary Care at Monroe

Pediatric Neurosurgery Associates, PC

Clearview Primary Care of Social Circle

Pediatric Partners

Clearview Regional Medical Center

Pediatric Surgery Practice - CHOA

Clearview Surgical Specialists & Vein Center

Pediatrics at Oconee Health Campus

Clearview Urgent Care

Pediatrics Health Center

Clearview Women's Healthcare

Pediatrix Medical Group of Georgia, PC

Clearview Wound Healing Center

Perimeter Clinic

Clinical Research Atlanta

Perimeter Plastic Surgery

Cobb Eye Center, LLP

Perry Family Practice

Collier B Gladin Jr MD

Personal Touch Medical Center

Colon & Digestive Health Specialists LLC

Peter Ulbrich, MD, PC

Colon and Digestive Health Specialists

Phoenix Medical at College Park

Community Care Clinic

Piedmont Anesthesia Associates

Community Internal Medicine of Athens

Piedmont Colorectal Associates

Comprehensive Care Associate

Piedmont Ear Nose Throat and Related Allergy

Comprehensive Care Medical Offices

Piedmont ENT & Related Allergy, PC

Comprehensive Healthcare of North Georgia

Piedmont Gynecology and Obstetrics

Comprehensive Spine and Pain

Piedmont Internal Medicine

Page 10: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Comprehensive Vascular Surgery of GA

Piedmont Medical Associates

Concentra

Piedmont Minor Emergency Clinic

Concierge Medicine of Columbus

Piedmont Nephrology and Internal Medicine

Concordia Anesthesiology

Piedmont OBGYN

Coney and Minter Internal Medicine

Piedmont Physicians Wound Care Walton

Consultative Gastroenterology

Piedmont Podiatry

Conyers Internal Medicine

Piedmont Psychiatric Clinic

Conyers Pediatrics

Piedmont Radiology

Covenant Care Pediatrics

Piedmont Rheumatology Consultants

Covenant Family Medicine

Piedmont South Imaging

Covenant Medical Center

Piedmont Surgery Specialists

Covington Pediatrics

Piedmont Surgical Associates, LLC

Covington Women's Health Specialists

Piedmont Urgent Care by Wellstreet

Cowry Medical Group, LLC

Piedmont Urology, PC

CPM Advanced Surgical Specialists, LLC

Pinnacle Health Group

Crabapple Family Medicine

Pinnacle Orthopaedics and Sports Medicine Specialists

Cranford Powell and Morris Advanced Surgical Specialists

Pittman Plastic Surgery

Crawford Plastic Surgery

Plastic and Reconstructive Surgery of Atlanta

Creative Care Health Concepts, LLC

Plastic Surgery of Athens, PC

Creekside Medical Clinic

Pleasant Pediatrics

Cross Care Direct Family Medicine

Polaris Medical Group - ENT

CV Clopton Jr. MD PC

Polaris Spine and Neurosurgery

CVG Physicians Group, LLC

Ponder's Podiatry

Cynthia B Chambless MD

Potts & Smith Pediatric & Adolescents PC

Cynthia L Giles DO

Pradeep K. Sinha, MD, PC

Danielsville Family Practice

Premier Dermatology and Mohs Surgery of Atlanta

David Fields, MD Family Care

Premier Family Medicine and Urgent Care Center

David P. Timmis, DDS, PC

Premier Opthamology, LLC

David S Lockman, MD

Premier Women's Health Care

Dawsonville Family Medicine

Premiere Image Cosmetic and Laser Surgery

Decatur Pediatric Group

PreventClinic

Dekalb Family Medicine, PC

Primary Care at Oconee Health Campus

Dekalb Medical

Primary Medical Care

Dekalb Medical Physicians Group

Prime Time Health Centers, Inc.

Dekalb Medical Specialty Care Group

Primera Foot and Ankle Centers

DeKalb Pathology, PC

Princeton Lakes Internal Medicine

DeKalb Pediatric Center, PC

Privia Medical Group of Georgia

Page 11: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Denise C De Veranez MD

Proactive Physicians of Marietta

Dermatology Affiliates

Proactive Physicians of Marietta

Dermatology and Skin Surgery Center PC

ProDocs

Dermatology Associates of Georgia

Progressive Medical Group

Dermatology Center of Atlanta

Prompt Medical Care

Dermatology Center of Newton-Rockdale

Pulliam Eye

Dermatology Consultants

Pulmonary & Sleep Medicine Center of Winder

Dewitt & Chisolm

Pulmonary & Sleep Specialist of Northeast Georgia

DHP of Piedmont

Pulmonary & Sleep Specialists

Diabetes & Endocrinology Associates, PC

Pulmonary and Sleep Medicine Associates

Diagnostic Imaging

Quality Nighthawk Teleradiology Group

Diagnostic Imaging Specialists

Quantum Medical Radiology

DiFrancesco Plastic Surgery

Radiant Womens Health

Digestive Diseases Clinic

Radiation Oncology Services

Digestive Healthcare of Georgia

Radiology and Medical Imagery of Newnan

Dione Marcus Super

Radiology and Medical Imagery of Newnan Inc

Donald A Selph Jr MD

Radiology Associates of Atlanta

Donald J. Pirozzi, M.D., P.C.

Radiology Associates of North Georgia

Douglas Surgical Associates

Radiotherapy Clinics of Georgia

Dr Edward D Frederickson MD

Ralph Peeler III MD

Dr Siruvella, MD, PC

Ratchford and McDaniel

Dr Thomas R Fitzsimmons

Rattandeep Singh MD

Dr. Crawford F. Barnett, Jr.

Rausch Family Medicine

Dr. Nesrudin I. Hamid, MD

Raybon OB-GYN

Dr. Richard N Stephens MD

Real Time Neuromonitoring Associates

Dr. Speed's Global Breast Health

Redding Allergy and Asthma Specialists

Drs Lacey & Freschi PC

Reddy Pediatrics

Dublin Internal Medicine

Regenerative Orthopaedics and Spine Institue

Dwana M Bush MD

Regenerative Orthopaedics and Spine Institute

Eagles Landing Bone & Joint

Regional Boutique

Eagles Landing Family Practice

Regional Lactation Center

Eagles Landing Gastroenterology

Regional Obstetrics and Gynecology

Eagles Landing Gastroenterology, PC

Regional Oncology

Eagles Landing Longevity Center

Rehabilitation Medicine & EMG Center PC

Eagles Landing Nephrology and Hypertension

Remote Neuromonitoring Physicians

Eagles Landing OBGYN Associates

Reproductive Biology Associates

Eagles Landing OBGYN Associates Lab

Reproductive Endocrinology and Infertility

Eagles Landing Pediatric Associates, LLC

Reproductive Endocrinology and Infertility Group

Eagles Landing Surgery

Resurgens Orthopaedics

Page 12: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Ear Nose and Throat Specialists

Resurgeons

Ear Nose Throat and Allergy Specialists

Resurgeons Orthopaedics

Ear, Nose and Throat Specialists

Richard E. Paul, DMD, PC

Early Family Practice Center

Richard Stappenbeck, MD, PC

East Atlanta Cardiology

Richardson & Goodman

East Atlanta Cardiology LLC

Richardson & Lyon

East Atlanta Gastroenterology Associates

Rigsby Internal Medicine, PC

East Atlanta Gynecology Associates

Riverdale Anesthesia Associates

East Metro Internal Medicine, LLC

Riverdale Surgery Anesthesia Associates

East Metro Orthopaedics

Riverwoods Behavioral Health System

East Metro Rheumatology, LLC

Robert Brian Raybon, MD

Eastside Internal Medicine

Robert F Gomez, MD, PC

Eastside OrthoCare

Robert H. Spector, MD

Eastside Premier Nephrology & Hypertension, PC

Robert V DiMeglio MD

Eastview Internal Medicine

Robyn J. Levy, MD, PC

Egleston Children's Hospital

Rockdale Anesthesia Services

Elbert County Internal Medicine

Rockdale County Radiation Therapy Center

EmCare - Hospitalists

Rockdale Family Practice

EmCare, Inc - South Division

Rockdale Medical Center

EmCare/Envision ED Physicians

Rockdale Newton Hematology Oncology

EmCare/Envision Emergency Medicine

Rockdale Pediatrics Healthcare PC

EmergiNet

Rockdale Physician Practices

Emory at Eagles Landing Family Practice

Rockdale Surgical Center

Emory Clinic-Cardiovascular & Thoracic

Rodney N Kreider MD PC

Emory Gastroenterology at Spivey Station

Ronald P. Martin, DMD, PC

Emory Healthcare Network Advantage

Rossana Y Carter MD

Emory Heart and Vascular Center

Rush Nephrology, LLC

Emory Internal Medicine of Newton County

Russell G O'Neal MD

Emory Southern Heart Specialists

Rutland Family Healthcare

Emory Specialty Associates - The Doc Office

S Rao Cheti MD

Emory Sports Medicine

Sandra Adamson Fryhofer, MD., M.A.C.P

Endocrine and Diabetes Consultants

Sandra Hall, MD, PC

Endocrine Consultants, P.C. (Newnan)

Savannah Neurology Specialists, PC

Endocrine Specialist of Athens

Schilling Healthcare Enterprise

Endocrinology & Diabetes Consultants, PC

Schilling Women's Center

ENT & Allergy Specialists

Schumacher Clinical Partners

ENT of Athens

Schumacher Coweta Emergency Group

Envision Physician Services

Schumacher-Fayette Emergency Group

Erik Thor Bendiks MD, PC

Scott Medical Consultants LLC

Page 13: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Esophageal Institute of Atlanta

Scottish Rite Pediatric Partners INC

Essential Medical Care

Select Interventional Pain PC

Etowah Pathology Associates, LLC

Setia & O'Neal

Evan Fliegel, MD, PC

Shashi Madan, PC

Excalibur Anesthesia Associates

Shashikant Patil MD

Excellent Pediatrics

Shelnutt Obstetrics & Gynecology PC

Eye Care Centers Management, Inc.

Shepherd Center

Eye Center of Central Georgia

Shepherd Pain Institute

Eye Consultants of Atlanta

Sheryl G. Bear, Ph.D.

Fairburn Southpark Medical & Surgical

Sholes Center for Womens Health

Famaks Consult

Shroff & Desai, MD, PC

Family Care of Hillandale

Shubang N. Mazumdar, MD

Family First Healthcare

Sibley Heart Center Cardiology

Family Medical Clinic of McDonough

Simpson Surgery Group

Family Medicine & Urgent Care, PC

Skin Cancer Specialist, PC

Family Practice and Urgent Care Associates

Skyline Neuroscience

Family Practice Center

Sleep and Lung Specialists

Family Practice of Conyers

Sleep and Sinus Centers of Georgia

Fayette Area Dermatology

Sleep Medicine Associates of Athens

Fayette Surgical Clinic & Breast Cente

Sleep Practitioners

Fayette Wound and Hyperbaric

Smith-Lambert Clinic

Fayetteville Family Practice

Sound Orthopaedics

Fiona O'Reilly Zwald

South Atlanta Ear Nose & Throat

First Georgia Physician Group Pediatrics

South Atlanta ENT/ENT of Georgia

First Georgia Physicians Group, LLC

South Atlanta Hematology Oncology

Five County Foot Care

South Atlanta Neurology & Diagnostics

Folsom C Proctor III MD

South Atlanta Neurology & Spine Clinic PC

Foot & Ankle Reconstruction of North Georgia

South Atlanta Neurology and Diagnostic

Foot and Ankle Institute of Georgia

South Atlanta Neurosurgery

Foot and Ankle Reconstruction of North Georgia

South Atlanta Radiology Associates

Forest Park Medical Group

South County Eye Clinic

Forrest Doud, M.D.

South Metro Bone and Joint

Foundation Psychiatry, PC

South Oral and Maxillofacial Surgery

GA Bone & Joint Surgeons, P.C.

South Suburban Pathologists PC

GA Emergency Medicine Specialists

Southeast Surgical Assisting

GA Universal Lungs

Southeastern Gynecologic Oncology, LLP

Gardner Dermatology

Southeastern Lung Care PC

Gary R. Gropper, MD, PC

Southeastern Neurology Associates

Gastroenterology Associates of Central Georgia

Southeastern Primary Care Specialists

Page 14: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Gastroenterology Atlanta, LLC

Southern Crescent ENT

Gastroenterology of Athens

Southern Crescent Family Practice

Gastroenterology Specialists of Gwinnett

Southern Crescent Nephrology

Gateway Family Practice

Southern Crescent Neurological Clinic

Gayla J Dillard MD

Southern Crescent Pediatrics

Genesis Eldercare Physician Services, Inc

Southern Crescent Plastic Surgery, PC

Genesys Gyn, Inc.

Southern Crescent Primary Care, PC

Gentiva Hospice

Southern Crescent Radiation Oncolocy Center

George L Aubley MD

Southern Crescent Surgical Assistants

George L Smith III MD, PC

Southern Crescent Womens Health Specialists

Georgia Arrhythmia Consultants and Research Institute

Southern Crescent Womens Healthcare

Georgia Bone and Joint

Southern Gastroenterology Specialists

Georgia Breast Surgery, PC

Southern Heart Specialists

Georgia Cancer Specialists, PC

Southside Kidney Clinics

Georgia Cardiovascular

Southside Kidney Clinics, PC

Georgia Center for ENT

Southwest Atlanta Nephrology

Georgia Center for Sight

SpecialtyCare

Georgia Colon & Rectal Surgical Associates

Spectrum Surgical Assisting, LLC

Georgia Dermatology

Spelman College Student Health Services

Georgia Dermatology Specialists of Coweta County PC

Spine Care & Pain Management

Georgia Emergency Medicine Specialists

St. Mary's Healthcare System

Georgia Eye Associates

Starrs Mill Internal Medicine

Georgia Eye Associates, PC

Starr's Mill Internal Medicine

Georgia Family Care

Stephen Lober Plastic Surgery

Georgia Family Practice

Stockbridge Pediatrics

Georgia Foot and Ankle

Subrahmanya Bhat, MD

Georgia Gynecologic Oncology

Summit Radiology Services

Georgia Hand Shoulder and Elbow

Sunil Patel MD

Georgia Hand Shoulder and Elbow PC

Super Dermatology

Georgia Heart Specialists

Surgery South

Georgia Heart Specialists LLC

Surgical and Cosmetic Dermatology PC

Georgia Imaging Associates

Surgical Assistants Of Georgia

Georgia Internal Medicine

Surgical Associates of Metro Atlanta

Georgia Kidney Consultants

Surgical Medical Associates

Georgia Kidz Pediatrics

Surgical Oncology of North Georgia

Georgia Lung Associates, PC

Sutton Orthopaedics and Sports Medicine

Georgia Medical Group

Swallowing Specialists of Central Georgia

Georgia Mountain Dermatology

T Douglas Gurley MD

Page 15: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Georgia Mountain Endocrinology Corp.

Tamara Brown MD

Georgia Mountain Ophthalmology LLC

Tate Medical Associates

Georgia Neonatology, LLC

Taylor, Suarez, Cook, Carrol and Adams

Georgia Nephrology

TeamHealth

Georgia Neurological Surgery

TeamHealth Acute Care Services

Georgia Neurology

TeamHealth Hospitalists

Georgia OB/GYN

TeamHealth OBGYN Hospitalists

Georgia Opthamologists

TeamHealth, Inc.

Georgia Pain and Spine Care

TEG Piedmont

Georgia Pediatric Cardiology

Teresa E Clark MD

Georgia Perinatal Consultants

Thacker and Thompson MD

Georgia Plastic Surgery & Recnstructive Care, PC

Thaddeus K Lynn, MD, PC

Georgia Renal and Hypertension Care

The Allergy & Asthma Center

Georgia Renal Associates

The Center for Internal and Integrative Medicine

Georgia Renal Specialist

The Dermatology Center of Newton and Rockdale

Georgia Reproductive Specialist

The Emory Clinic

Georgia Retina PC

The Georgia Center for Ear Nose & Throat and Facial Plastic Surgery

Georgia Rheumatology Clinic, PC

The Healthy Woman

Georgia Skin Care & Aesthetic Dermatology

The Heart Center, LLC

Georgia Specialist of Coweta County

The Heart Clinic, PC

Georgia Surgical Professional Associates

The Hughston Clinic

Georgia Surgicare LLC

The Kaufmann Clinic

Georgia Urology

The Kidney Clinic

Georgia Vascular Specialists

The Kids Specialists/Henry Pediatrics

Gilbert Pathology, PC

The Moore Center

Gleneagles Surgery

The Multiple Sclerosis Center of Georgia, Inc.

Glenn Family Wellness Clinic

The Pain Specialist Group

Glenn S Shear MD

The Pediatric Center

Goetzinger Eye Institute

The Physical Medicine and Rehab

Gore Medical Management

The Radiology Group

Gray Family Health

The Reddy Aesthetic Institute

Great Expressions Dental Center

The Southeast Permanente Medical Group, Inc

Greater Anesthesia Services

The Urology Clinic

Greater Athens Physicians, Inc

The Womens Center

Greater Atlanta Womens Healthcare Assoc.

Therapeutic Radiation Oncology

Gregory Erdelyan MD

Thomas B. Faulkner, MD, LLC

Greystone OBGYN

Thomas D. Berry, DMD

Griffin Radiation Oncology Center, LLC

Thomas E. Moak, M.D.

Page 16: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Gumucio Center for Plastic Surgery

Thomas Eye Group

Gumucio Plastic Surgery

Thomas N Kias MD

Gwinnett Consultants in Cardiology, PC

Thomas W. Goggin

Gwinnett Dermatology

TIVA Healthcare

Gwinnett Heart Specialist

TMB Medical Associates PC

Gwinnett Hospital System, Inc.

Transitional Care Physicians of Georgia

Gwinnett Neonatology PC

Tri-County Pediatrics

Gynecologic Oncology Specialists of Atl

TriStar Health

Hailey,Brody, Casey & Wray MD PC

TriStar Middle Tennessee Neurology

Hand and Upper Extremity Center of GA

TriStar Teleneurology

Hanowell Pain Management

Triumph Radiology Associates

Hanowell Spine Clinic

Truffles Vein Specialists

Harbin Clinic, LLC

Tuan Minh-G Nguyen, LLC

Harris Medical Associates

Tyrone Family Medicine

Harry C. Tindall, M.D.

UGA Health Sciences

Harry M. Foster, Jr., M.D., P.A.

UGA University Health Center

Harsch & Osborne MD

United Obstetrics and Gynecology

Hawthorne Medical Associates

Universal Lung Associates

Health Care First

Universal Radiology Consultants

Health Mount LLC

University Cancer and Blood Center

Heart and Vascular Care of Georgia

University of Arkansas for Medical Sciences

Heart of Georgia Rheumatology

University Surgical Vascular

Heartland Healthcare

Urology Clinical Services

Heindel ENT, LLC

Urology Group of Athens

Henry Anesthesia Associates

Urology of Atlanta, LLC

Henry County Pediatrics

Urology of Greater Atlanta

Henry County Radiology Associates

USTeleradiology, LLC

Henry Internal Medicine

V.N. Murthy, MD & James Swails, MD

Henry OB/GYN Associates

Varma S Meka MD

Henry OBGYN Associates

VDS Surgical Assistans

Heras Healthcare for Women

Vein Clinics of America

Hidden Valley Medical Center

Venture Medical Associates, LLC

Hometown Pediatrics

Victor A Crosby, MD

Houston Plastic and Craniofacial Surgery

Village Podiatry Group

Howard Ellison MD

Village Podiatry Group II

Hubbard Pediatrics

Vine Medical Associates, PC

Hurteau Plastic Surgery

Vinings Medical Center

Hushen Lalani MD

Virtual Medical Staff

Hypertension & Kidney PC

Virtual Radiologic Professionals LLC

Page 17: Financial Assistance Policy Provider Appendix...Financial Assistance Policy Provider Appendix Updated in October 2018 The following is a list of practices rendering care at Piedmont

Financial Assistance Policy Provider Appendix

Updated in October 2018

Hypertension and Kidney Center

Vision Radiology

Ideal Gynecology

Visiting Nurse Health System, Hospice Atlanta

Ideal Gynecology 2

VISTA Staffing Solutions

In Compass Health Inc

Vitas Healthcare

Indian Lake Neurology/TriStar Tele-Neurology

VN Murthy, MD & James Swails, MD

Infectious Disease Consultants

W Jason Woods

Infectious Disease Professionals

Walnut Creek Family Practice

Infectious Disease Specialist of Athens

Walton Anesthesia Associates

Infectious Disease Specialists Atlanta

Walton Childrens Clinic

Infectious Diseases Associates

Walton Family Medicine

Infinite Health

Walton Pulmonary and Sleep Medicine

Innovative Women's Healthcare Solutions

Wayne S Morris, MD, PC

Internal Medicine & Geriatrics

Weatherby Healthcare

Internal Medicine Associates of Columbus

Wellness First

Internal Medicine Associates of Jasper

Wellspring Medical Center

Internal Medicine Associates of Jasper, PC

Wellstar Gynecology Oncology

Internal Medicine Associates Of Middle Georgia

Wellstar Medical Group

Internal Medicine Associates of Rockdale

Wellstreet of Georgia PC

Internal Medicine Specialists of Atlanta

William M Hudson MD PC

Interventional Management Services

William Roundtree MD PC

Interventional Spine and Pain Management Center

WMC Tyrone, LLC

InTouch Health

Women’s Health Institute at Stockbridge

Intown Infectious Diseases

Women's Center of Athens

J Dewayne Colquitt FACS MD

Women's Comprehensive Healthcare Center

Jackson and Coker

Women's Health Associates Of Walton, PC

James F Zumstein MD

Womens Health Institute Of Stockbridge

James G Burson MD LLC

Womens Health Specialists

James McDonald, DMD/Richard Manus, DMD

Women's Healthcare Associates

James T Sandwich MD PC

Womens Healthcare Associates of Athens

Jasper Neurological Associates

Womens Medical Center

Jayson Phelps

Women's Medical Center

Jefferson Pediatrics

Women's Telehealth

Jeffrey T Nugent MD

Woolfson Eye Institute

JenCare Neighborhood Medical Center East Point

Zotec

JenCare Neighborhood Medical Centers Druid Hills, LLC