PPO Physician Search
As a value based purchasing coalition, SBG contracts with providers setting rates and reimbursements, access points, and services. We seek out all services necessary for a self funded plan to have an inclusive arrangement to use as their preferred provider network for their health plan. SBG uses a direct to provider contracting model.
Since its launch in 1986 our network has experienced dynamic growth. Today we offer a two hospital health system, a physician network, pharmacy managers, home care, laboratory, and all other necessary ancillary services including repricing and an out of area wrap network.
- St. Joseph’s Candler Health System
- Candler Hospital
- St. Joseph’s Hospital
- Telfair Women’s Hospital
- The Care Network (over 700 physicians)
- The Mayo Clinic – Jacksonville
If you are a small business with traditional fully funded insurance needs SBG recommends that you consider self funding.
SBG has been able to negotiate additional service features beyond the traditional network offerings, listed below are some examples of such features.
- Every mother that delivers at the Candler Hospital will receive a free car seat
- Bearly Sick: This program offers free daycare to your employees children that are too sick for school or daycare but not sick enough to have their parent stay home.
- Care Call Center: Employee resource for nurse triage, network directory info, scheduling and support group info.
- Taxi: For those patients that who are unable to keep their scheduled appointments due to transportation difficulties the network will assist by arranging a taxi to transport the patient to their scheduled appointment.
- Patient Representative (a contact at each hospital for patients if they have any problems or concerns reports back to SBG monthly on problems or concerns if any arise.)
- Meal Card: immediate family members of SBG patients at Candler or St. Josephs Hospital are provided cafeteria meal passes.
The SBG network operates as a Preferred Provider Organization (PPO). Participating providers are required to:
- participate in and support Utilization review process
- participate in and support Quality improvement Programs
- meet credentialing requirements
- accept reimbursement rates
Hospitals are required to maintain quality assurance programs and certifications.
Physicians are obligated to accept fees as full payments with no balance billing for covered services.
Coalition members are independent self insured health plans and maintain control of their own plan designs. Each employer member may select their own administrators and choose which SBG contract they participate in.
Repricing and Data Warehouse:
SBG has contracted to provide claims repricing at no cost to members. This agency will receive and reprice claims to assure correct contract pricing. Claims are then forwarded to the member’s administrator; electronic submission is our preferred method. This agency captures claims data and warehouses the data to support SBG’s performance incentive programs.