U
United Healthcare Corp.
9900 Bren Road E., Minnetonka, Minn. 55343; 612-797-4851; fax: 612-797-2581
Utilization Review/Case Management
1996 revenues
Total gross revenue*$5,670,000,000
Covered lives/reviewed admissions
Acute care inpatient admissions reviewed**200,135
UR/case mgmt. services since: 1984.
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, hospital bill audits, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings.
Occasional services: Onsite case management, second surgical opinion, written reports.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric, home care.
Branch offices: Sacramento and San Diego, Calif.; Glastonbury, Conn.; Tampa, Fla.; Chicago; Westborough, Mass.; Golden Valley, Minn.; Kingston, N.Y.; Dayton, Ohio; Oklahoma City; Dunbar, W.Va.
Officers: Dr. William W. McGuire, chairman/president/CEO; David P. Koppe, CFO; Travers H. Wills, Jeannine M. Rivet, Sheila T. Leatherman, executive vps.
Contact: Shirley P. Burr, market director.
**1995 total revenues. ***Estimate. Does not include network-based UR services.
United Review Services
67 Walnut Ave., Suite 405, Clark, N.J. 07066; 908-815-0330; fax: 908-382-2035
Utilization Review/Case Management
1996 revenues
Total gross revenue$3,500,000
UR revenue$87,000
Case mgmt. revenue$400,000
UR/case mgmt. direct to employers4%
Svcs. to managed care/insurance providers11%
Other services85%
Staff
Total UR/case management employees9
UR/case mgmt. employees on retainer5
Clients
Corporate/institutional employer clients7
Covered lives/reviewed admissions
Employee benefit plan lives served15,000
Acute care inpatient admissions reviewed931
Diverted for outpatient treatment3.5%
UR/case mgmt. services since: 1989.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, onsite case management, review of lab work, patient education, retrospective review, hospital bill audits, outpatient service predetermination, referrals to alternative settings, written reports.
Occasional services: Telephone case management, free prescreening, second surgical opinion, outpatient psychiatric and substance abuse services.
Medical services reviewed/managed: Group health, dental, chiropractic, rehabilitation, psychiatric/substance abuse, workers comp/disability, pediatric.
Compensation: $1.25 to $2 per employee per month; per case; $90 to $105 per hour.
Officers: Terry Wallace, president/treasurer; Dorothy Maxemow, Marie Wallace, vps.
Contact: Risa Gordon, account executive.
V
Value Behavioral Health Inc.
3110 Fairview Park Drive S.,
Falls Church, Va. 22042; 703-205-7000;
fax: 703-876-5644
Utilization Review/Case Management
1996 revenues
Total gross revenue$223,082,746
UR revenue$3,454,884
Case mgmt. revenue$168,718,538
UR/case mgmt. direct to employers*77.5%
Svcs. to managed care/insurance providers*7.7%
Other services*14.8%
Staff
Total UR/case management employees329
Clients
Total20
Covered lives/reviewed admissions
Employee benefit plan lives served24,000,000
UR/case mgmt. services since: 1983.
Parent: Value Health Inc.
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, outpatient service predetermination, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Occasional services: Onsite case management, hospital bill audits.
Medical services reviewed/managed: Psychiatric/substance abuse.
Branch offices: Long Beach, Calif.; Skokie, Ill.; Boston; Southfield, Mich.; St. Louis; New York and Troy, N.Y.; Research Triangle Park, N.C.; Irving, Texas.
Compensation: Per employee per month; per case; per hour.
Officers: Charlton "Chip" Tooke, president/CEO; Edith Jardine, executive vp-national sales/marketing; Julie Bigelow, COO-public sector division; Tina Blasi, COO-commercial division; Dr. Ian Shaffer, chief medical officer.
** BI estimate.
Value Care Review-WPS
1717 W. Broadway, P.O. Box 8190, Madison, Wis. 53717; 800-333-5003;
fax: 608-223-3625
Utilization Review/Case Management
1996 revenues
Total gross revenue$212,000,000
UR/case mgmt. direct to employers6%
Other services94%
Staff
Total UR/case management employees40
Professionals25
UR/case mgmt. employees on retainer6
Clients
Total16,410
Covered lives/reviewed admissions
Employee benefit plan lives served190,824
Acute care inpatient admissions reviewed13,564
Diverted for outpatient treatment5%
UR/case mgmt. services since: 1992.
Parent: Wisconsin Physicians Service.
Frequent services: Preadmission certification, concurrent hospital treatment review, length of stay determination, discharge planning, telephone case management, free prescreening, retrospective review, outpatient psychiatric and substance abuse services, referrals to alternative settings, written reports.
Occasional services: Onsite case management, review of lab work, patient education, second surgical opinion, outpatient service predetermination.
Medical services reviewed/managed: Group health, chiropractic, rehabilitation, psychiatric/substance abuse, pediatric.
Compensation: $2.45 per employee per month; $75 per hour.
Officers: Jim Riordan, president-WPS; Bill Bathke, executive vp-WPS; Tim Heaton, CEO-EPIC; Dr. Gerald Kempthorne, vp-medical affairs.
W
Worldwide Auditing
Services & Worldwide
Rehab Consultants
100 W. Main St., Suite 500, P.O.
Box 149, Lansdale, Pa. 19446; 215-362-0206; fax: 215-362-6362
Utilization Review/Case Management
1996 revenues
Total gross revenue$2,000,000
UR revenue$1,200,000
Case mgmt. revenue$500,000
UR/case mgmt. direct to employers2%
Svcs. to managed care/insurance providers83%
Other services15%
Staff
Total UR/case management employees25
Professionals16
UR/case mgmt. employees on retainer6
Clients
Total170
Corporate/institutional employer clients1
UR/case mgmt. 1980.
Parent: Lehigh Valley Services Inc.
Services: Onsite and telephone case management, retrospective review, hospital bill audits.
Medical services reviewed/managed: Chiropractic, rehabilitation, workers comp/disability.
Branch offices: Linthicum, Md.
Compensation: $200 to $700 per case; $63 to $68 per hour.
Officers: John J. Haney, CEO; Allan F. Mohr, COO; Doreen Whitney, director-professional services.
Contact: Allan F. Mohr.