DIRECTORY OF UR PROVIDERS AND CASE MANGERS ( C )

C
CCMI Associates Inc.
P.O. Box 377, Francestown, N.H. 03043; 603-547-2245; fax: 603-547-2246
Case Management
1996 revenues
Total gross revenue*$1,500,000
Case mgmt. direct to employers5%
Svcs. to managed care/insurance providers85%
Other services10%
Staff
Total case management employees5
Professionals5
UR/case mgmt. employees on retainer1
Clients
Total25
Corporate/institutional employer clients5
Covered lives/reviewed admissions
Acute care inpatient admissions reviewedNA
Diverted for outpatient treatment90%
Case mgmt. services since: 1989.
Frequent services: Concurrent hospital treatment review, discharge planning, onsite case management, review of lab work, patient education, free prescreening, referrals to alternative settings, written reports, identification of resources, provision of family/client support.
Occasional services: Preadmission certification, length of stay determination, telephone case management, second surgical opinion, hospital bill audits, outpatient service predetermination, outpatient psychiatric and substance abuse services.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Portland, Maine; Wakefield, Mass.
Compensation: $65 per hour.
Contact: Sandra L. Lowery, president/CEO.
**Estimate.
CNR Health Inc.
2514 S. 102 St., Milwaukee,
Wis. 53227-2132; 800-654-5160 or 414-327-5197; fax: 414-327-0886
Utilization Review/Case Management
1996 revenues
Total gross revenue$16,342,333
UR/case mgmt. revenue$11,555,969
UR/case mgmt. direct to employers33%
Svcs. to managed care/insurance providers38%
Other services29%
Staff
Total UR/case management employees41
Professionals41
Clients
Total65
Corporate/institutional employer clients54
Covered lives/reviewed admissions
Employee benefit plan lives served740,100
UR/case mgmt. services since: 1988.
Parent: United Wisconsin Services Inc. (joint venture partnership).
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.
Occasional services: Hospital bill audits.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, prenatal, home care; physical, speech and occupational therapy; targeted outpatient diagnostic procedures (MRIs).
Branch offices: Midland, Mich.; Houston and Lake Jackson, Texas.
Compensation: Per employee per month; per case; per hour.
Officers: Ralph Cavaiani, president; Dianne Kiehl, executive vp; Louise Murphy, vp-southwest region; Pete Levine, national medical director-southwest region; Dr. Barry Blackwell, national medical director-northern region.
Contact: Northern region: Elizabeth Ferris, business development director, 800-654-5160. Southern region: Shirley Cortez, senior sales consultant, 800-554-6171.
CRA Managed Care Inc.
312 Union Wharf, Boston, Mass. 02109; 617-367-2163; fax: 617-367-8519
Utilization Review/Case Management
1996 revenues
Total gross revenue$190,750,000
UR revenue$67,450,000
Case mgmt. revenue$121,300,000
UR/case mgmt. direct to employers11%
Svcs. to managed care/insurance providers88%
Other services1%
Staff
Total UR/case management employees2,750
Professionals1,300
UR/case mgmt. employees on retainer50
Clients
Total1,258
UR/case mgmt. services since: 1978.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite and telephone case management, retrospective review, second surgical opinion, hospital bill audits, outpatient service predetermination, referrals to alternative settings, written reports.
Occasional services: Review of lab work, patient education, free prescreening, outpatient psychiatric and substance abuse services.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability.
Branch offices: 115 field locations; 62 cost-containment locations.
Officers: Donald J. Larson, president/CEO; Joseph F. Pesce, CFO/treasurer/senior vp-finance/administration; John A. McCarthy Jr., senior vp-corporate development; Peter R. Gates, senior vp-marketing/sales; Anne E. Kirby, vp-marketing/product development.
Contact: Anne E. Kirby.
Cannon Cochran Management Services Inc. dba MSI compSolutions
2 E. Main St., Towne Centre Building, Danville, Ill. 61832; 217-446-1089;
fax: 217-443-0927
Utilization Review/Case Management
1996 revenues
Total gross revenue$25,631,000
UR revenue$450,000
Case mgmt. revenue$18,500
UR/case mgmt. direct to employers0.9%
Svcs. to managed care/insurance providers0.1%
Other services99%
Staff
Total UR/case management employees6
Professionals6
UR/case mgmt. employees on retainer6
Clients
Total900
Covered lives/reviewed admissions
Employee benefit plan lives served14,000
Workers compensation lives served120,000
UR/case mgmt. services since: 1995.
Parent: Cannon Cochran Management Services Inc.
Frequent services: Concurrent hospital treatment review, length of stay determination, discharge planning, outpatient service predetermination, referrals to alternative settings.
Occasional services: Preadmission certification, onsite and telephone case management, review of lab work, patient education, free prescreening, retrospective review, second surgical opinion, hospital bill audits, outpatient psychiatric and substance abuse services, written reports.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Margate, Fla.; Atlanta; Oakbrook, Ill.; Des Moines, Iowa; Metairie, La.; Kansas City and St. Louis, Mo.
Officers: Robert L. Cowgill, chairman/CEO; Gary J. Schirmer, vice chairman; Stephen W. Ferguson, president/COO; G. Bryan Thomas, Steven L. Luebbert, executive vps.
Contact: Annie Mariage, 800-252-5059 ext. 200.
CAPP CARE
4000 MacArthur Blvd., Suite 10000, Newport Beach, Calif. 92660; 714-251-2200; fax: 714-251-2222
Utilization Review/Case Management
1996 revenues
Total gross revenue$30,000,000
UR revenue$9,000,000
Case mgmt. revenue$2,500,000
UR/case mgmt. direct to employers20%
Svcs. to managed care/insurance providers20%
Other services60%
Staff
Total UR/case management employees50
Professionals38
UR/case mgmt. employees on retainer8
Clients
Total260
Covered lives/reviewed admissions
Employee benefit plan lives served1,400,000
Acute care inpatient admissions reviewed102,000
Diverted for outpatient treatment18%
UR/case mgmt. services since: 1982.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, review of lab work, patient education, second surgical opinion, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Occasional services: Onsite case management, retrospective review.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, pediatric.
Compensation: $1.75 to $3.60 per employee per month; $115 per hour (case management); $1.40 per employee per month (UR pre-certification).
Officers: Ed Zalta, chairman; Mike Henry, president/CEO; Nouri Zalta, executive vp/COO; Greg Hamblin, CFO; Roberta Holtzman, senior vp-operations; Frank Stevens, senior vp-PPO/provider affairs; Rick Hardeman, vp-customer service; Karen Linden, vp-information technology.
Contact: Jeanine Scalero, marketing communications coordinator, 714-251-2200 ext. 7409.
CareAdvantage Health Systems Inc.
485-C Route 1 South, Iselin,
N.J. 08830-3037; 908-602-7000;
fax: 908-602-7027
Utilization Review/Case Management
1996 revenues
Total gross revenue$16,000,000
UR revenue$13,000,000
Case mgmt. revenue$3,000,000
UR/case mgmt. direct to employers5%
Svcs. to managed care/insurance providers95%
Staff
Total UR/case management employees130
UR/case mgmt. employees on retainer124
Clients
Total6
Corporate/institutional employer clients1
Covered lives/reviewed admissions
Employee benefit plan lives served140,000
Acute care inpatient admissions reviewed140,000
UR/case mgmt. services since: 1994.
Parent: CareAdvantage Inc.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, review of lab work, retrospective review, outpatient service predetermination, referrals to alternative settings.
Occasional services: Onsite case management, patient education, second surgical opinion, written reports.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, pediatric.
Compensation: Per employee per month; per case; percent of savings.
Officers: Thomas Riley, CEO-CareAdvantage Inc.; Dr. Robert Ailes, CEO-CareAdvantage Health Systems Inc.; Richard Strobel, CFO; Dr. Stephan Deutsch, chief medical officer.
Contact: Dr. Robert J. Ailes, 908-602-7005.
Case Management
Choices Inc.
4237 Salisbury Road, Suite 207, Jacksonville, Fla. 32216; 800-227-3317 or 904-279-0077; fax: 904-279-0082
Utilization Review/Case Management
1996 revenues
Total gross revenue$260,000
UR revenue$65,000
Case mgmt. revenue$195,000
UR/case mgmt. direct to employers85%
Svcs. to managed care/insurance providers15%
Staff
Total UR/case management employees10
Covered lives/reviewed admissions
Workers compensation lives served35,000
UR/case mgmt. services since: 1990.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite and telephone case management, second surgical opinion, outpatient service predetermination, referrals to alternative settings, written reports.
Occasional services: Retrospective review, hospital bill audits, outpatient psychiatric and substance abuse services.
Medical services reviewed/managed: Group health, chiropractic, psychiatric/substance abuse, workers comp/disability.
Compensation: Per employee per month; per case; per hour.
Officers: Michael N. Kowlsen, president; Tina M. Kowlsen, vp.
Catastrophic & Rehabilitation Management Inc.
2735 Clyde Park Ave. S.W., Grand Rapids, Mich. 49509; 616-531-4040;
fax: 616-531-4070
Case Management
1996 revenues
Total gross revenue$260,000
Case mgmt. revenue$120,000
UR/case mgmt. direct to employers28%
Svcs. to managed care/insurance providers18%
Other services54%
Staff
Total UR/case management employees3
Professionals3
Covered lives/reviewed admissions
Workers compensation lives served70
UR/case mgmt. services since: 1991.
Frequent services: Concurrent hospital treatment review, discharge planning, onsite and telephone case management, review of lab work, patient education, second surgical opinion, referrals to alternative settings, written reports.
Occasional services: Preadmission certification, length of stay determination, retrospective review, hospital bill audits, outpatient service predetermination.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric, catastrophic.
Compensation: Per hour, $70 to $130.
Contact: Charlotte Stein.
Community Care
Network (CCN)*
5251 Viewridge Court, San Diego, Calif. 92123; 619-278-2273; fax: 619-278-8621
Utilization Review/Case Management
1996 revenues
Total gross revenue$91,771,000
UR revenue$1,100,000
Case mgmt. revenue$1,700,000
UR/case mgmt. direct to employers1%
Svcs. to managed care/insurance providers2%
Other services97%
Staff
Total UR/case management employees105
Professionals67
UR/case mgmt. employees on retainer162
Clients
Total3,971
Corporate/institutional employer clients2,778
Covered lives/reviewed admissions
Employee benefit plan lives served1,759,523
Workers compensation lives served13,000,000
Acute care inpatient admissions reviewed14,854
Diverted for outpatient treatment5.3%
UR/case mgmt. services since: 1984.
Parent: Value Health Inc.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, retrospective review, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Occasional services: Hospital bill audits.
Medical services reviewed/managed: Group health, dental (southern California only), chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Phoenix; Long Beach, Calif.; Gulfport and Jackson, Miss.
Compensation: $1.10 to $1.50 per employee per month; $96 to $105 per hour.
Officers: James E. Buncher, president/CEO; Debra Cerre-Ruedisili, senior vp/COO; Shannon Johnston, senior vp/chief administrative officer; Patrick Sullivan, senior vp/chief marketing officer; Dr. Eugene Helsel, medical director.
Contact: Patrick Sullivan.
**Community Care Network (CCN) and MedView are wholly owned subsidiaries of Value Health Inc. Please refer to MedView's listing for additional information.
ComPsych Behavioral Health
NBC Tower, 24th Floor, Chicago, Ill. 60611; 312-595-4000; fax: 312-595-4029
Utilization Review/Case Management
1996 revenues
Total gross revenue*$50,000,000
UR revenue*$10,000,000
Case mgmt. revenue*$10,000,000
UR/case mgmt. direct to employers20%
Svcs. to managed care/insurance providers20%
Other services60%
Staff
Total UR/case management employees29
Clients
Total18
Corporate/institutional employer clients12
Covered lives/reviewed admissions
Employee benefit plan lives served1,200,000
Acute care inpatient admissions reviewed2,400
Diverted for outpatient treatment75%
UR/case mgmt. services since: 1989.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, telephone case management, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, employee assistance services.
Occasional services: Discharge planning, onsite case management, patient education, retrospective review, written reports.
Medical services reviewed/managed: Psychiatric/substance abuse.
Compensation: $0.75 to $15 per employee per month; $250 to $1,250 per case; $75 to $150 per hour.
Officers: Dr. Richard A. Chaifeta, CEO; David S. Levine, senior vp; Dr. Ewa Antonowicz, clinical director; Adam Gottskind, counsel; Bob Jacobson, CFO.
Contact: Ed Foss, 312-595-4021.
**Estimate.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Utilization Review/Case Management
1996 revenues
Total gross revenue$118,000,000
UR revenue$9,500,000
Case mgmt. revenue$61,000,000
UR/case mgmt. direct to employers14%
Svcs. to managed care/insurance providers45%
Other services41%
Staff
Total UR/case management employees997
Professionals840
UR/case mgmt. employees on retainer180
Clients
Total450
Corporate/institutional employer clients65
Covered lives/reviewed admissions
Workers compensation lives served6,100,000
Acute care inpatient admissions reviewed33,860
Diverted for outpatient treatment4%
UR/case mgmt. services since: 1975.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite and telephone case management, retrospective review, second surgical opinion, hospital bill audits, outpatient service predetermination, referrals to alternative settings, written reports, concurrent outpatient UR, integration of all UR services with case management and bill audit services.
Occasional services: Outpatient psychiatric and substance abuse services.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric, auto, first- and third-party liability claims, physical therapy, prescription, physical medicine.
Branch offices: 150 locations nationwide.
Compensation: UR: $1.25 to $1.40 per employee per month; $110 to $150 per case. Case management: $70 to $73 per hour.
Officers: Gordon Clemons, president; Lou Silverman, vp-operations; Daniel Davis, vp-marketing; Richard Schweppe, CFO; Don McFarlane, vp-information technology.
Contact: Daniel Davis, 215-953-5060.
Cost Care Inc.
660 Newport Center Drive, Suite 600, Newport Beach, Calif. 92660; 800-451-0000 or 714-729-4500;
fax: 714-729-4668
Utilization Review/Case Management
1996 revenues
Total gross revenue$46,000,000
UR revenue$28,000,000
Case mgmt. revenue$17,000,000
UR/case mgmt. direct to employers85%
Svcs. to managed care/insurance providers12%
Other services3%
Staff
Total UR/case management employees576
Professionals341
Clients
Total782
Corporate/institutional employer clients383
Covered lives/reviewed admissions
Employee benefit plan lives served2,937,101
Acute care inpatient admissions reviewed165,654
UR/case mgmt. services since: 1981.
Parent*: John Hancock Mutual Life Insurance Co.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, review of lab work, patient education, retrospective review, second surgical opinion, hospital bill audits, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings.
Occasional services: Onsite case management, written reports, disease state management.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Huntington Beach, Calif.; Atlanta; Chicago; Boston; Jackson, Miss.
Compensation: Per employee per month; per case; per hour.
Officers: Robert A. Vohs, president/CEO; Cheryl Y. Perkins, senior vp-operations; Dena Parker, vp-finance; Randy Schwartz, vp-operations; Dr. Robert Crocker, medical director.
Contact: Scott Schilling, national sales director, 800-762-4528 or 770-319-8101.
**Cost Care Inc. is expected to be acquired by Unicare on January 31, 1997.
Crawford & Co.
5620 Glenridge Drive, Atlanta, Ga. 30342; 404-256-0830; fax: 404-847-4028
Utilization Review/Case Management
1996 revenues
Total gross revenue$633,625,000
UR revenue$20,095,000
Case mgmt. revenue$86,276,000
UR/case mgmt. direct to employers13%
Svcs. to managed care/insurance providers6%
Other services81%
Staff
Total UR/case management employees65
Clients
Total1,500
Corporate/institutional employer clients1,021
Covered lives/reviewed admissions
Employee benefit plan lives served422,762
Acute care inpatient admissions reviewed19,144
Diverted for outpatient treatment0.1%
Services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite and telephone case management, review of lab work, patient education, free prescreening, retrospective review, second surgical opinion, hospital bill audits, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Medical services reviewed/managed: Group health, dental, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Officers: D.A. Smith, chairman/CEO; J.R. Bryant, president/COO-risk management; A.L. Meyers, president/COO-claims; G.L. Box, president-international; D.R. Chapman, executive vp.
Contact: Dick Calhoun, assistant vp-sales.