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DIRECTORY OF UR PROVIDERS AND CASE MANGERS ( E )

Posted On: Feb. 2, 1997 12:00 AM CST

E
E.M. Associates Inc.
520 Columbia Drive, Johnson City, N.Y. 13790; 607-770-0070; fax: 607-770-8709
Utilization Review/Case Management
1996 revenues
Total gross revenue$1,200,000
UR/case mgmt. direct to employers30%
Svcs. to managed care/insurance providers30%
Other services40%
Staff
Total UR/case management employees20
Professionals11
UR/case mgmt. employees on retainer22
Clients
Total45
Covered lives/reviewed admissions
Employee benefit plan lives served5,000
Workers compensation lives served800
Acute care inpatient admissions reviewed1,000
Diverted for outpatient treatment5%
UR/case mgmt. services since: 1987.
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, hospital bill audits, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Buffalo, Rochester and Syracuse, N.Y.
Compensation: $1.75 to $3 per employee per month; $65 to $150 per hour.
Officers: K. Ernst, president; H. Holland, vp-professional services; S. Outman, vp-operations; S. Miller, vp-quality/development.
Contact: K. Ernst.
E-V Benefits Management Inc.
1900 E. Dublin-Granville Road, Columbus, Ohio 43229; 614-895-4000; fax: 614-895-4995
Utilization Review/Case Management
1996 revenues
Total gross revenue$2,069,138
UR/case management revenue$157,239
UR/case mgmt. direct to employers8%
Other services92%
Staff
Total UR/case management employees3
Professionals2
UR/case mgmt. employees on retainer5
Clients
Corporate/institutional employer clients15
Covered lives/reviewed admissions
Employee benefit plan lives served7,400
Acute care inpatient admissions reviewed1,500
Diverted for outpatient treatment2%
UR/case mgmt. services since: 1992.
Services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, retrospective review, second surgical opinion, outpatient service predetermination, referrals to alternative settings.
Medical services reviewed/managed: Group health, dental, chiropractic, rehabilitation, psychiatric/substance abuse, pediatric.
Compensation: $1.25 to $3.50 per employee per month; $75 to $100 per hour.
Officers: Jim Eggert, chairman/CEO; Gary Van Azsdale, president/COO; Gregory Nickell, vp.
Ellis & Associates Inc.
745 McClintock Drive, Suite 200,
Burr Ridge, Ill. 60521; 630-887-4747;
fax: 630-887-4077
Case Management
1996 revenues
Total gross revenue$4,200,000
Case mgmt. revenue$3,360,000
UR/case mgmt. direct to employers20%
Svcs. to managed care/insurance providers60%
Other services20%
Staff
Total UR/case management employees32
Clients
Total236
Corporate/institutional employer clients35
UR/case mgmt. services since: 1979.
Parent: Ellis Enterprises.
Frequent services: Onsite and telephone case management, hospital bill audits.
Medical services reviewed/managed: Group health, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Branch offices: Chicago and Peoria, Ill.; Indianapolis; St. Louis; Appleton and Milwaukee, Wis.
Compensation: $70 to $85 per hour.
Officers: Cindy R. Ellis, president.
Employee Benefit Management Services Inc.
P.O. Box 21367, Billings, Mont. 59104-1367; 406-245-3575;
fax: 406-259-7871
Utilization Review/Case Management
1996 revenues
Total gross revenue$4,272,000
UR revenue$343,469
Case mgmt. revenue$42,852
UR/case mgmt. direct to employers8%
Svcs. to managed care/insurance providers1%
Other services91%
Staff
Total UR/case management employees5
Professionals5
UR/case mgmt. employees on retainer1
Clients
Total97
Covered lives/reviewed admissions
Employee benefit plan lives served42,000
Acute care inpatient admissions reviewed2,362
Diverted for outpatient treatment0.08%
UR/case mgmt. services since: 1989.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, outpatient service predetermination, referrals to alternative settings, written reports.
Occasional services: Onsite case management, review of lab work, patient education, retrospective review, second surgical opinion, outpatient psychiatric and substance abuse services.
Medical services reviewed/managed: Group health, rehabilitation, psychiatric/substance abuse, pediatric.
Compensation: $2 to $2.50 per employee per month; $100 per hour.
Officers: Frederick H. Larson, president; Nicki Larson, vp.
Contact: Frederick H. (Rick) Larson.
ENCOMPASS Health Management Systems
6000 Westown Parkway, Suite 350E, West Des Moines, Iowa 50266-7771; 515-223-2857; fax: 515-222-2407
Utilization Review/Case Management
1996 revenues
Total gross revenue$25,000,000
UR revenue$10,500,000
Case mgmt. revenue$6,500,000
UR/case mgmt. direct to employers60%
Svcs. to managed care/insurance providers8%
Other services32%
Staff
Total UR/case management employees199
Professionals133
UR/case mgmt. employees on retainer334
Clients
Total186
Corporate/institutional employer clients177
Covered lives/reviewed admissions
Employee benefit plan lives served4,200,000
Workers compensation lives served1,500,000
Acute care inpatient admissions reviewed183,500
Diverted for outpatient treatment12%
UR/case mgmt. services since: 1975.
Parent: Iowa Foundation for Medical Care.
URAC certified.
Frequent services: Preadmission certification, concurrent hospital treatment review, discharge planning, telephone case management, 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, high risk maternity review.
Occasional services: Length of stay determination, review of lab work.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric, home health, skilled nursing facility, intensive care facilities.
Branch offices: Chicago and Peoria, Ill.; Baltimore; Minneapolis; Lincoln, Neb.
Compensation: $1.65 to $2.25 per employee per month; per case; $85 to $150 per hour.
Officers: Kathy R. Fliehler, vp; Michael Larson, national sales director; Elodie Opstad, director-provider services; Sheri Ivey, director-utilization management; Jeffrey D. Stahl, medical director.
Contact: Kathy R. Fliehler.