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DIRECTORY OF UR PROVIDERS AND CASE MANGERS ( Q )

Reprints

Q

QMC 3 Inc.

10 Lakeside Lane, Denver, Colo. 80212; 303-433-6898; fax: 303-433-7696

Utilization Review/Case Management

1996 revenues

Total gross revenue$180,000,000

UR revenue$54,000,000

Case mgmt. revenue$90,000,000

UR/case mgmt. direct to employers30%

Svcs. to managed care/insurance providers50%

Other services20%

Staff

Total UR/case management employees1,600

UR/case mgmt. employees on retainer20

Clients

Total1,258

Corporate/institutional employer clients920

Covered lives/reviewed admissions

Employee benefit plan lives served3,000,000

Workers compensation lives served10,000,000

Acute care inpatient admissions reviewed130,000

Diverted for outpatient treatment30%

UR/case mgmt. services since: 1987.

Parent: CRA Managed Care Inc.

URAC certified.

Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, patient education, retrospective review, second surgical opinion, outpatient service predetermination, outpatient psychiatric and substance abuse services, written reports.

Occasional services: Onsite case management, review of lab work, free prescreening, hospital bill audits, referrals to alternative settings.

Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.

Compensation: $0.25 to $1.75 per employee per month; $0.75 to $2 per case; $0.40 to $0.70 per hour.

Officers: Kimberly Sutphin, president; Dorothy Anderson, COO; Don Larson, president-CRA; John McCarthy, vp-CRA.

Contact: Kim Sutphin.

Quality Managed Care Inc.

7245 W. 95th St., Suite 200, Overland Park, Kan. 66212; 913-642-7997;

fax: 913-642-4201

Utilization Review/Case Management

1996 revenues

Total gross revenue$2,000,000

UR revenue$800,000

Case mgmt. revenue$1,200,000

UR/case mgmt. direct to employers18%

Svcs. to managed care/insurance providers82%

Staff

Total UR/case management employees29

Professionals29

UR/case mgmt. employees on retainer20

Clients

Total125

Corporate/institutional employer clients16

Covered lives/reviewed admissions

Employee benefit plan lives served305,218

Workers compensation lives served11,025

Acute care inpatient admissions reviewed2,205

Diverted for outpatient treatment22%

UR/case mgmt. services since: 1989.

Parent: The Olsten Corp.

Frequent services: Preadmission certification, concurrent hospital treatment review, discharge planning, telephone case management, patient education, free prescreening, retrospective review, second surgical opinion, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.

Occasional services: Length of stay determination, onsite case management, hospital bill audits.

Medical services reviewed/managed: Group health, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric, OB/Gyn, skilled care, home health.

Branch offices: Denver; West Palm Beach, Fla.; Chicago; Wichita, Kan.; Philadelphia.

Compensation: Per employee per month; per case; per hour.

Officers: Noreen E. Whalen, vp/general manager.

Contact: Margaret Cutkosky, regional marketing representative, 630-443-9256.