Printed from BusinessInsurance.com

1997 DIRECTORY OF MANAGED CARE PROVIDERS

Posted On: Dec. 28, 1997 12:00 AM CST

Washington
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: Washington: King County.
See AnciCare PPO consolidated listing under Florida.
CNA Managed Care-Seattle
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Primary practitioners445
Specialists1,397
Hospitals23
Primary care locations8Service area: Washington: Seattle.
See CNA Managed Care POS consolidated listing under Illinois.
CNA Managed Care-Seattle
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners4,253
Hospitals36
Service area: Washington: Seattle.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Spokane
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners622
Hospitals17
Service area: Washington: Spokane.
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*421
Board-certified54.5%
Patients/practitioner6.7
Hospitals16
Service area: Washington: Clark, Cowlitz, King, Kitsap, Pierce, Skamania, Snohomish, Spokane and Yakima 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 practitioners84
Service area: Washington: statewide.
See ChiroSource Inc. consolidated listing under California.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners3,148
Board-certified86%
Specialists10,325*
Hospitals134
Service area: Washington.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
Ethix Northwest
600 University St., Suite 1400, Seattle, Wash. 98101; 206-447-0757; 206-447-0762
Staff/Facilities
Primary practitioners2,531
Specialists5,488
Hospitals64
Pharmacies850
Users: Group Health
Employees & dependents107,777
Total Users107,777
Ownership: NYLCare Health Plans Inc.
Operational date: January 1985.
For profit.
Service area: Alaska: Cities of Anchorage, Fairbanks, Juneau and North Star; Idaho: Kootenai County; Montana: Yellowstone County; Washington: statewide. Contracts with Express Scripts for prescription drug in Washington and NBN Vision for vision in Washington.
Services: General medical, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers, insurers; charges flat fee per employee, by percent of savings, by percent of services by doctors/hospitals.
UR: Standard procedures excluding hospital bill audits and outpatient service predetermination. UR provided by the PPO.
Officers: David E. Ford, president; Steve Roberts, senior vp-marketing; Dr. Jeff Robertson, medical director; Molly Swain, director-marketing/communications; Kathy Odegard, senior director-operations.
First Choice Health Network Inc.
601 Union St., Suite 700, Seattle, Wash. 206-667-8050; 206-667-8060
Staff/Facilities
Primary practitioners2,587
Specialists4,549
Hospitals88
Users: Group Health
Employer/payer groups8,000
Employees & dependents460,000
Operational date: September 1985.
For profit.
Service area: Alaska: city of Anchorage; Idaho: Benewah, Bonner, Kootenai, Latah and Shoshone counties; Montana: Lake and Yellowstone counties; Washington: statewide.
Contracts with Chiropractic Network Services for chiropractic in Washington; Managed Health Care Northwest for general medical in Oregon.
Services: General medical, dental, vision, mental health, chiropractic. Services available unbundled.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers, providers, insurers, TPAs; charges flat fee per employee, by percent of savings.
UR: Standard procedures, excluding hospital bill audits. UR provided by the PPO.
Officers: Gary Gannaway, president/CEO; David Peel, CFO; Ross Heyl, vp/chief marketing officer; Judy Sarafin, vp-operations; Dr. Ric Winstead, medical director/vp-network management.
Group Health Cooperative of Puget Sound
521 Wall St., Seattle, Wash. 98121; 206-448-4140; fax: 206-448-4271
Staff/Facilities
Primary practitioners1,002
Board-certified87.5%
Patients/practitioner856
Specialists2,398
Hospitals66
Pharmacies312
Primary care locations259
Users
Employer/payer groups3,417
Single coverage108,119
Family coverage106,771
Medicare63,617
Medicaid65,896
Total710,137
Revenues
1996$1,144,325,000Licensed in: Idaho and Washington.
NCQA fully accredited.
Model type: Group/IPA/Staff/Network.
Not for profit.
Service area: Idaho: Benewah, Bonner, Kootenai, Latah and Shoshone; Washington: 32 counties.
Member of The HMO Group, Ultralink, HBA, CODA.
Services: General medical, vision, prescription drug, mental health, chemical dependency. Services available unbundled. May be customized to meet employer specifications.
Community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 25% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Cheryl Scott, president; Dr. Louise Liang, medical director; Jim Truess, CFO; Richard Marks, vp-marketing/health insurance services; Dorothy Teeter, vp-information systems.
Group Health Northwest
5615 W. Sunset Highway, Spokane Wash. 99224; 509-838-9100;
fax: 509-459-1080
Staff/Facilities
Primary practitioners468
Board-certified84%
Specialists758
Hospitals46
Pharmacies207
Primary care locations149
Users
Employer/payer groups991
Single coverage13,844
Family coverage41,227
Employees & dependents125,012
Medicare8,205
Medicaid36,128
Total187,876
Revenues
First-half 1997$13,593,620
1996$20,859,861Parent: Group Health Cooperative of Puget Sound.
Operational date: July 1977.
Federally qualified.
Licensed in: Idaho, Washington.
NCQA one year accredited.
Model type: Group/Staff.
Not for profit.
Service area: Idaho: Benewah, Bonner, Kootenai, Latah and Shoshone counties; Washington: Benton, Chelan, Columbia, Douglas, Franklin, Grant, Kittitas, Klickitat, Lincoln, Okanogan, Spokane, Stevens, Walla Walla, Whitman and Yakima counties and parts of Adams, Ferry and Pend Oreille counties.
Member of The HMO Group.
Services: General medical, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 16% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Dr. Henry S. Berman, president; Dr. Jack Dutzar, vp-medical affairs; Sharon Fairchild, vp-marketing/sales; Sue Merk, vp-information systems, Dr. Ruth Langstraat, associate medical director.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*1,366
Specialists2,524
Hospitals**35
Service area: Washington: 31 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
INS Inc.
19515 N. Creek Parkway, Suite 302, Bothell, Wash. 98011; 425-486-7170; fax: 425-486-7906
Staff/Facilities
Primary practitioners632
Specialists3,207
Hospitals33
Total Users400,000
Operational date: November 1989.
For profit.
Service area: Washington: King, Lewis, Pierce, Snohomish and Thurston counties.
Services: General medical, mental health. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by discount of customary rates, DRGs; is compensated by employers/payers, insurers; charges by percent of savings.
UR: UR provided by outside contractors.
Officers: Pauline Nefcy, president; Brad Becker, vp-provider relations; Wes Strietzel, director-operations.
Contact: Brad Becker.
Kaiser Foundation Health Plan of the Northwest
500 N.E. Multnomah St., Suite 100, Portland, Ore. 97232; 503-813-2800; fax: 503-813-4636
Staff/Facilities
Primary practitioners213
Board-certified95%
Patients/practitioner1,958
Specialists349
Hospitals8
Pharmacies37
Primary care locations13
Users
Employer/payer groups4,472
Single coverage108,579
Family coverage50,711
Employees & dependents340,503
Medicare47,204
Medicaid28,682
Total415,560
Revenues
First-half 1997$388,645,026
1996$751,735,741Federally qualified.
Licensed in: Idaho, Oregon, Washington.
NCQA fully accredited.
Model type: Group.
Not for profit.
Service area: Oregon: Benton, Clackamas, Columbia, Lane, Linn, Marion, Multnomah, Polk, Washington and Yamhill counties; Washington: Clark, Cowlitz, Lewis, Skamania and Wahkiakum.
Services: General medical, dental, vision, prescription drug, mental health, workers compensation, durable medical equipment, hospitalization, lab, x-ray, preventive medicine, health education, substance abuse, chiropractic. Services available unbundled. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Offers self-insured products.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Michael Katcher, executive director-Kaiser/Group Health; Dr. Allan Weiland, medical director-Northwest Permanente; Barbara A. West, senior vp-Kaiser/Group Health/executive director-Kaiser Permanente Northwest division; Denise Honzel, marketing director-Kaiser/Group Health; Wade J. Overgarrd, manager sales/marketing-Kaiser/Group Health.
Contact: Lynn Bonner, 503-813-4826.
See Kaiser Permanente consolidated listing under California.