DIRECTORY OF UR PROVIDERS AND CASE MANGERS (I, J)

I
IntegraHome
11499 Chester Road, Cincinnati, Ohio 45246; 513-772-9009; fax: 513-772-9111
Utilization Review/Case Management
1996 revenues
Total gross revenue*$8,000,000
UR/case mgmt. direct to employers35%
Svcs. to managed care/insurance providers10%
Other services55%
Staff
Total UR/case management employees12
Professionals12
UR/case mgmt. employees on retainer30
Clients
Total41
Corporate/institutional employer clients74
Covered lives/reviewed admissions
Employee benefit plan lives served30,610
Acute care inpatient admissions reviewed3,787
Diverted for outpatient treatment3%
UR services since: 1991.
Parent: Integra Group.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Occasional services: Onsite case management, review of lab work, patient education, retrospective review, second surgical opinion, hospital bill audits.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Compensation: $1.85 to $2.50 per employee per month.
Officers: William D. Stief, CEO; Mary J. Hanley, president; Vincent J. Homan, executive vp.
Contact: Jerry Schwartz, vp.
**Estimate.
Intracorp
2 Liberty Place, 1601 Chestnut St., Philadelphia, Pa. 19192; 215-761-7100;
fax: 215-761-7458
Utilization Review/Case Management
1996 revenues
Total gross revenue$322,600,000
UR revenue$74,100,000
Case mgmt. revenue$47,900,000
UR/case mgmt. direct to employers14.8%
Svcs. to managed care/insurance providers74.1%
Other services47.9%
Staff
Total UR/case management employees3,485
Professionals1,042
UR/case mgmt. employees on retainer438
Clients
Total1,059
Corporate/institutional employer clients682
Covered lives/reviewed admissions
Employee benefit plan lives served20,100,000
Workers compensation lives served3,500,000
Acute care inpatient admissions reviewed486,318
Diverted for outpatient treatment5.8%
UR services since: 1984.
Parent: CIGNA.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite and telephone case management, review of lab work, patient education, retrospective review, second surgical opinion, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports, specialty care review.
Occasional services: Hospital bill audits.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: 65 locations in the United States and Canada.
Compensation: Per employee per month; per case; percent of savings.
Officers: Dennis J. Mouras, president; John Weymer, senior vp-group health managed care; Larry Doele, senior vp-disability management; Maddy Bowling, senior vp-workers comp managed care; Ken Ross, senior vp-fee management.
Contact: Betty J. Nelson, manager-public relations, 215-761-7146.
IPRO
1979 Marcus Ave., Lake Success,
N.Y. 11042; 516-326-7767;
fax: 516-326-7791
Utilization Review/Case Management
1996 revenues
Total gross revenue$30,000,000
UR/case mgmt. direct to employers25%
Svcs. to managed care/insurance providers25%
Other services50%
Staff
Total UR/case management employees200
UR/case mgmt. employees on retainer600
Clients
Total35
Corporate/institutional employer clients5
Covered lives/reviewed admissions
Acute care inpatient admissions reviewed180,000
UR services since: 1984.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, telephone case management, retrospective review, second surgical opinion, hospital bill audits, written reports.
Occasional services: Discharge planning, onsite case management, outpatient service predetermination, referrals to alternative settings.
Medical services reviewed/managed: Group health, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Albany, N.Y.; South Burlington, Vt.
Compensation: $1.55 to $2.55 per employee per month; $125 to $300 per case; $100 to $175 per hour.
Officers: Dr. Thomas J. Sheehy Jr., president; Theodore O. Will, executive vp; Harry Feder, senior vp; Dr. Raphael Nenner, vp-medical affairs.
Contact: Robin J. Husney.
J
Jordan Services
900 Merchants Concourse, Suite 112, Westbury, N.Y. 11590; 516-683-0100; fax: 516-683-0259
Utilization Review/Case Management
1996 revenues
Total gross revenue$5,800,000
UR revenue$785,000
Case mgmt. revenue$3,685,000
UR/case mgmt. direct to employers11%
Svcs. to managed care/insurance providers67%
Other services22%
Staff
Total UR/case management employees63
Professionals47
UR/case mgmt. employees on retainer11
Clients
Total580
Corporate/institutional employer clients23
Covered lives/reviewed admissions
Employee benefit plan lives served14,500
Workers compensation lives served17,060
Acute care inpatient admissions reviewed972
Diverted for outpatient treatment12%
UR services since: 1974.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite and telephone case management, review of lab work, retrospective review, second surgical opinion, hospital bill audits, outpatient service predetermination, outpatient psychiatric and substance abuse services, written reports.
Occasional services: Patient education, free prescreening, referrals to alternative settings.
Medical services reviewed/managed: Group health, dental, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric, long-term disability.
Branch offices: Iselin, N.J.; Rochester, N.Y.; Philadelphia
Compensation: $1.50 to $4.50 per employee per month; $375 to $1,500 per case; $75 per hour.
Officers: Morris Ehrenreich, Maureen Armstrong, Joan Jennings, Phyllis Snow, Sandy Horowitz.
Contact: Phyllis Snow.