1997 DIRECTORY OF MANAGED CARE PROVIDERS

Iowa
AnciCare PPO
3700 Lakeside Drive, Suite 401, Miramar, Fla. 33027-3225; 800-414-4674; fax: 305-826-7482
Specialty: workers compensation/medical diagnostic imaging
Staff/Facilities
Primary practitioners2
Hospitals1
Service area: Iowa: Clinton.
See AnciCare PPO consolidated listing under Florida.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners407
Specialists829
Hospitals20
Users: Group Health
Single coverage8,499
Family coverage33,257
Employees & dependents84,990
Users: Workers Compensation
Single coverage2,128
Total Users87,118
Operational date: 1990.
Service area: Iowa: 59 counties.
See Beech Street Corp. consolidated listing under California.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners184
Board-certified70.1%
Patients/practitioner0.7
Specialists290
Hospitals6
Users: Group Health
Employer/payer groups46
Employees & dependents835
Users: Workers Compensation
Employer/payer groups31
Total Users*835
Service area: Iowa: Adair, Blackhaw, Bremer, Clinton, Dickinson, Linn, Madison, Marshall, Polk, Scott and Webster counties.
Services: General medical, mental health, workers compensation, ancillary services.
**Does not include workers compensation users.
See CCN consolidated listing under California.
CNA Managed Care-Eastern Iowa
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners698
Hospitals13
Service area: Iowa: Eastern Iowa.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-West Iowa
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners633
Hospitals12
Service area: Iowa: West Iowa.
See CNA Managed Care PPO consolidated listing under Illinois.
CAPP CARE Inc.
West Tower, 4000 MacArthur Blvd., Suite 10000, Newport Beach, Calif. 92660; 800-937-2277; fax: 714-251-2222
Staff/Facilities
Primary practitioners*439
Board-certified67.2%
Patients/practitioner60.9
Hospitals16
Service area: Iowa: Black, Cass, Clarke, Dallas, Decatur, Fayette, Hawk, Marion, Polk, Pottawattamie, Scott, Warren and Webster counties.
**Includes specialists.
See CAPP CARE Inc. consolidated listing under California.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners18
Service area: Iowa: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA Managed Care Network-Des Moines
525 W. Monroe St., Suite 1800, Chicago, Ill. 60661-3629; 312-648-2460; fax: 312-648-3617
Staff/Facilities
Primary practitioners155
Board-certified69.5%
Patients/practitioner9
Specialists330
Hospitals4
Users
Employer/payer groups40
Total1,408Operational date: January 1996.
Licensed in: Illinois, Iowa.
Model type: IPA.
Service area: Iowa: Boone, Dallas, Jasper, Madison, Marion, Marshall, Polk, Story and Warren counties.
Point-of-service contracts: 41.6% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Bert Wagener, general manager; Dr. Richard Balsamo, medical director; Jim Watson, assistant vp-network management; Don O'Connell, vp-sales; Ken Hendrickson, director-quality management.
Contact: Brett Reinholz.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Des Moines
525 W. Monroe St., Suite 1800, Chicago, Ill. 60661; 312-648-2460; fax: 312-648-3617
Staff/Facilities
Primary practitioners181
Board-certified75.4%
Patients/practitioner54.5
Specialists377
Hospitals6
Users: Group Health
Employer/payer groups164
Total Users9,874
Operational date: April 1992.
Service area: Iowa: Boone, Dallas, Jasper, Madison, Marion, Marshall, Polk, Story and Warren counties.
Officers: Dan O'Connell, vp-sales; Bert Wagener, general manager; Dr. Richard Balsamo, medical director; Adam Wolf, director-client services; Mike Gilmartin, sales director/manager.
Contact: Kathleen Gillanders, 860-726-5784.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners257
Board-certified97%
Specialists896*
Hospitals27
Service area: Iowa.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
ENCOMPASS Health Management Systems
6000 Westown Parkway, Suite 350E, West Des Moines, Iowa 50266-7771; 515-223-2857; fax: 515-222-2407
Staff/Facilities
Primary practitioners810
Specialists4,754
Hospitals103
Users: Group Health
Employer/payer groups10
Employees & dependents51,000
Users: Workers Compensation
Employer/payer groups2
Single coverage269,000
Total Users320,000
Operational date: March 1989.
For profit.
AAHC/URAC accreditation status: Health Utilization Management Standards; Workers Compensation Utilization Management Standards.
Service area: Arkansas: Baxter, Fulton, Izard and Marion counties; Florida: Manatee and Sarasota counties; Georgia: Bullock, Burke, Jenkins, Richmond and Screven counties; Illinois: Henry, Mercer, Rock Island and Whiteside counties; Iowa: Cedar, Clinton, Jackson, Johnson, Jones, Linn, Muscatine and Scott counties; Kentucky: Boyd, Campbell, Carter, Clay, Fayette, Floyd, Franklin, Greenup, Johnson, Laurel, Lawrence, Madison, Magoffin, Perry, Pike, Pulaski, Rock Castle and Whitley counties; Mississippi: Boliver, Coahoma, Copiah, Hinds, Holmes, Humphrey, LeFlore, Madison, Montgomery, Rankin, Scott, Simpson, Sunflower, Warren, Washington and Yazoo counties; Missouri: Boone, Carroll, Chariton, Cooper, Dade, Greene, Howard, Jasper, Johnson, Lafayette, Lawrence, Pettis, Saline and Webster counties; North Carolina: Avery, Buncombe, Burke, Davidson, Davie, Forsyth, Guilford, Henderson, McDowell, Mitchell, Randolph, Rowan, Rutherford and Yancey counties; Tennessee: Clay, Fentress, Jackson, Macon, Pickett, Smith, Sumner and Trousdale counties.
Services: General medical, mental health, vision, workers compensation, chiropractic. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures, including disease management. UR provided by the PPO.
Officers: Kathy R. Fliehler, vp; Michael Larson, national sales director; Elodie Opstad, director-marketing/business development; Dr. Jeffrey D. Stahl, medical director; Sheri Ivey, director-clinical review services.
Contact: Elodie Opstad, 515-223-2164 or Michael Larson, 612-540-0063.
FOCUS Healthcare Management Inc.
7101 Executive Center Drive, Suite 375, Brentwood, Tenn. 37207; 800-873-0055 or 615-377-9936; fax: 615-661-4042
Specialty: workers compensation
Staff/Facilities*
Primary practitioners351
Specialists1,352
Hospitals11
Total Users193,874
Operational date: September 1990.
Service area: Iowa: 68 counties.
**Includes leased providers/facilities.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
Great Rivers Network
745 Craig Road, Suite 218, St. Louis, Mo. 63141; 314-989-0011; fax: 314-989-0022
Staff/Facilities
Primary practitioners2
Board-certified100%
Specialists41
Hospitals1
Users: Group Health
Employer/payer groups1
Single coverage100
Family coverage150
Employees & dependents445
Total Users445
Service area: Iowa: Lee County.
See Great Rivers Network consolidated listing under Missouri.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*465
Specialists509
Hospitals**16
Service area: 86 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Iowa Managed Health Care Inc.
2750 First Avenue N.E., Suite 200, Cedar Rapids, Iowa 52402; 319-363-8705; fax: 319-363-8728
Specialty: mental health/substance abuse
Staff/Facilities
Specialists159
Hospitals6
Users: Group Health
Employer/payer groups4
Employees & dependents70,000
Users: Workers Compensation
Total Users70,000
Operational date: March 1991.
For profit.
Service area: Iowa: Benton, Buchanan, Cedar, Delaware, Dubuque, Jackson, Johnson, Jones, Linn and Winneshiek counties.
Services: Mental health. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by insurers; charges flat fee per employee, by percent of savings, by percent of services by doctors/hospitals, by repricing.
UR: Standard procedures excluding second surgical opinion. UR provided by the PPO.
Officers: Dr. Thomas W. Hansen, president; Dr. Alan C. Whitters, first vp; Dr. Ali Safdar, second vp; Dr. R. Paul Penningroth, treasurer; Philip D. Dorothy, secretary.
Contact: Philip D. Dorothy, 800-333-7737.
Medical Associates Health Plans
700 Locust St., P.O. Box 5002, Dubuque, Iowa 52001-6800; 319-556-8070;
fax: 319-556-5134
Staff/Facilities
Primary practitioners107
Board-certified95%
Patients/practitioner270
Specialists70
Hospitals17
Pharmacies72
Primary care locations36
Users
Employer/payer groups245
Single coverage3,471
Family coverage5,914
Employees & dependents22,916
Medicare7,329
Total30,245
Revenues
First-half 1997$17,748,000
1996$33,442,000Parent: Medical Associates Clinic P.C.
Operational date: August 1982.
Licensed in: Illinois, Iowa, Wisconsin.
NCQA one year accredited.
Model type: Group.
For profit.
Service area: Illinois: Jo Daviess County; Iowa: Allamakee, Clayton, Delaware, Dubuque, Jackson and Jones counties; Wisconsin: Crawford, Grant, Iowa and Lafayette counties.
Services: General medical, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating: $159 single, $404 family.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Lawrence E. Cremer, CEO; Ron Fahey, director-finance; Cindy Thumser, director-managed care; Darlene Walsh, director-operations; Karen Hoffmann, director-compliance/contracting.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners*NA
Specialists*NA
Hospitals20
Users: Group Health
Employer/payer groups8
Employees & dependents112,330
Service area: Maine: 35 counties.
**Practitioner network not yet established.
See MultiPlan Inc. consolidated listing under New York.
Mutually Preferred PPO
Mutual of Omaha Plaza, Omaha, Neb. 68175; 402-351-4255; fax: 402-351-2999
Staff/Facilities
Primary practitioners387
Specialists914
Hospitals13
Service area: Adams, Benton, Boone, Carroll, Crawford, Dallas, Fremont, Harrison, Jasper, Linn, Madison, Mills, Page, Polk, Pottawattamie, Story, Taylor, Union and Warren counties.
See Mutually Preferred PPO consolidated listing under Nebraska.
National Ear Care Plan
6825 E. Tennessee Ave., Suite 415, Denver, Colo. 80224-1632; 303-399-1212; fax: 303-399-7719
Specialty: hearing
Staff/Facilities
Primary practitioners24
Service area: Iowa: 33 cities.
See National Ear Care Plan consolidated listing under Colorado.
National Preferred Provider Network Inc.
419 E. Main St., Middletown, N.Y. 10940; 914-343-1600; fax: 914-343-6113
Staff/Facilities
Primary practitioners196
Specialists646
Hospitals22
Users: Group Health
Employer/payer groups23
Employees & dependents57,342
Total Users57,342
Service area: Iowa.
See National Preferred Provider Network Inc. consolidated listing under New York.
Preferred Health Network
301 E. Ocean Blvd., Suite 900, Long Beach, Calif. 90802; 562-983-1616; fax: 562-436-4389
Staff/Facilities
Primary practitioners214
Specialists283
Hospitals12
Users: Group Health
Employer/payer groups330
Employees & dependents32,159
Users: Workers Compensation
Employer/payer groups360
Single coverage181,520
Total Users213,679
Operational date: January 1989.
Service area: Iowa: 36 counties.
Services: General medical, vision, mental health, workers compensation.
See Preferred Health Network consolidated listing under California.
Principal Health Care Inc.-PPO, Iowa Division
4600 Westown Parkway, Suite 301, West Des Moines, Iowa 50266; 515-255-1234; fax: 515-223-0097
Staff/Facilities
Primary practitioners928
Board-certified73%
Specialists1,445
Hospitals236
Users: Group Health
Employer/payer groups26
Employees & dependents152,002
Total Users152,002
Operational date: February 1993.
Service area: Illinois: Henry and Rock Island counties; Iowa: 35 counties; Nebraska: Dakota and Dixon counties; South Dakota: Union County.
UR: Preadmission review, precertification, concurrent review, length of stay determination. UR provided by outside contractors.
Officers: Kenneth J. Linde, president/CEO; Robert Mrizek, vp/counsel; Sharon Taylor, David Weiss, vps.
Contact: Robin Talkington, 301-581-0600.
See Principal Health Care Inc.-PPO consolidated listing under Maryland.
Private Healthcare Systems Inc.
9399 W. Higgins Road, Suite 500, Rosemont, Ill. 60018; 847-292-6700;
fax: 847-292-6736
Staff/Facilities
Primary practitioners198
Board-certified81%
Specialists616
Hospitals21
Pharmacies699
Users
Employees & dependents50
Total50Service Area: Iowa: cities of Cedar Falls, Davenport, Des Moines, Moline, Rock Island and Waterloo.
See Private Healthcare Systems POS consolidated listing under Massachusetts.
Private Healthcare Systems
9399 W. Higgins Road, Suite 500, Rosemont, Ill. 60018; 847-292-6720; fax: 847-292-6796
Staff/Facilities
Primary practitioners657
Board-certified81
Specialists616
Hospitals21
Pharmacies699
Users: Group Health
Employees & dependents34,516
Total Users34,516
Operational date: May 1987.
Service area: Iowa: cities of Cedar Falls, Davenport, Des Moines, Moline, Rock Island and Waterloo.
See Private Healthcare Systems PPO consolidated listing under Massachusetts.
ProAmerica Managed Care
1250 E. Copeland Road, Arlington, Texas 76011; 800-523-3669; fax: 817-436-5391
Staff/Facilities
Primary practitioners28
Specialists80
Hospitals12
Users: Group Health
Employees & dependents16,000
Total Users16,000
Service area: Iowa: statewide.
See ProAmerica Managed Care consolidated listing under Texas.
USA H&W Network
7301 N. 16th St., Suite 201, Phoenix, Ariz. 85020; 602-371-3860; fax: 602-371-3889
Staff/Facilities
Primary practitioners549
Specialists560
Hospitals20
Users: Group Health
Single/family coverage22,215
Employees & dependents51,094
Total Users51,094
Operational date: September 1989.
Service Area: Iowa: 52 counties.
See USA H&W Network consolidated listing under Arizona.
USA Workers' Injury Network
916 S. Capital of Texas Highway, Austin, Texas 78746; 512-306-0201; fax: 512-328-6785
Specialty: workers compensation
Staff/Facilities
Primary practitioners392
Specialists572
Hospitals15
Users: Workers Compensation
Single coverage84,307
Total Users84,307
Operational date: August 1989.
Service area: Iowa: 52 counties.
See USA Workers' Injury Network consolidated listing under Texas.
United HealthCare Insurance Co.
2717 N. 118th Circle, Omaha, Neb. 68164-9672; 402-445-5000;
fax: 402-445-5575
Staff/Facilities
Primary practitioners140
Board-certified58%
Specialists282
Hospitals3
Users:
Employer/payer groups116
Total Users7,621
Operational date: January 1995.
Service area: Iowa: Dallas, Jasper, Polk and Warren counties.
Services: General medical, prescription drug, mental health/substance abuse.
Contact: Phil Barager, vp-sales.
See United HealthCare Corp. PPO consolidated listing under Minnesota.
Wellmark Select
500 Walnut, Suite 300, Des Moines, Iowa 50309; 515-246-6297; fax: 515-282-0719
Staff/Facilities
Primary practitioners1,549
Specialists3,176
Hospitals147
Users: Group Health
Employer/payer groups37
Single coverage16,918
Employees & dependents40,603
Ownership: Wellmark Administrators Inc.
Operational date: July 1992.
For profit.
AAHC/URAC accreditation status: Health Utilization Management Standards.
Service area: Illinois: Carroll, Fulton, Hancock, Henry, Jo Daviess, Knox, Mercer, Peoria, Rock Island, Tazewell, Whiteside; Iowa: statewide; Nebraska: 20 counties; Wisconsin: La Crosse County.
Services: General medical, mental health. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by discount off customary rates; is compensated by employers/payers; charges flat fee per employee, by percent of savings.
UR: Standard procedures, including prenatal screening program. UR provided by the PPO.
Officers: Paula Ryan, president; Sally Wood, COO; Sheri Vohs, vp-network development/management; Dr. Eric Book, Dr. Jeffrey VerHuel, medical directors.
Contact: Erik Stjernberg.