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1997 DIRECTORY OF MANAGED CARE PROVIDERS

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

Rhode Island
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities
Primary practitioners4
Specialists61
Hospitals5
Users
Employees & dependents2,035
Operational date: May 1992.
Service area: Rhode Island: Bristol, Kent, Newport, Providence and Washington counties.
See Admar Med Network consolidated listing under California.
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 practitioners1
Hospitals1
Service area: Rhode Island: Kent County.
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 practitioners48
Specialists624
Hospitals9
Users: Group Health
Single coverage1,619
Family coverage6,335
Employees & dependents16,189
Total Users16,189
Operational date: 1993.
Service area: Rhode Island: Bristol, Kent, Newport, Providence and Washington counties.
See Beech Street Corp. consolidated listing under California.
CNA Managed Care-Rhode Island
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners293
Hospitals4
Service area: Rhode Island.
See CNA Managed Care PPO consolidated listing under Illinois.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners3
Service area: Rhode Island: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA Manged Care Network of Rhode Island
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners171
Board-certified71%
Patients/practitioner4.1
Specialists536
Hospitals8
Pharmacies187
Users
Employer/payer groups90
Total718Operational date: January 1995.
Licensed in: Rhode Island.
Model type: IPA.
Service area: Rhode Island: Bristol, Kent, Providence and Washington counties.
Point-of-service contracts: 47.3% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: John Fetch, assistant vp-network development; Brian Wells, general manager; Dr. Imre Toth, medical director; Yvonne Mezolan, UM health services manager; Christine Bamforth, quality assurance manager.
Contact: Merry Sampson.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Rhode Island
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners133
Board-certified67.7%
Patients/practitioner17.2
Specialists416
Hospitals8
Users: Group Health
Employer/payer groups98
Total Users2,297
Operational date: January 1995.
Service area: Rhode Island: Bristol, Kent, Providence and Washington counties.
Officers: Brian Wells, general manager; Dr. Imre Toth, medical director, Carla Bettano, director-provider relations; Linda Schneider, planning/analysis-medical economics.
Contact: Andrew Green, 860-726-3586.
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 practitioners30
Board-certified90%
Specialists378*
Hospitals2
Service area: Rhode Island.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*79
Specialists221
Hospitals**6
Service area: Rhode Island: statewide.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Healthcare Value Management Inc.
100 River Ridge Drive, Suite 101, Norwood, Mass., 02062; 617-762-5511; fax: 617-762-5318
Staff/Facilities
Primary practitioners561
Specialists1,167
Hospitals11
Users: Group Health
Employees & dependents42,000
Service area: Rhode Island: statewide.
See Healthcare Value Management Inc. consolidated listing under Massachusetts.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners*NA
Specialists*NA
Hospitals8
Users: Group Health
Employer/payer groups1
Employees & dependents65,698
Service area: Rhode Island: Bristol, Kent, Newport, Providence and Washington counties.
**Practitioner network not yet established.
See MultiPlan Inc. consolidated listing under New York.
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 practitioners1
Service area: Rhode Island: city of Lincoln.
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 practitioners393
Specialists951
Hospitals8
Users: Group Health
Employer/payer groups10
Employees & dependents8,115
Total Users8,115
Service area: Rhode Island.
See National Preferred Provider Network Inc. consolidated listing under New York.
Private Healthcare Systems
1100 Winter St., Waltham, Mass. 02154; 781-895-7500; fax: 781-895-6848
Staff/Facilities
Primary practitioners138
Specialists133
Hospitals3
Pharmacies171
Users: Group Health
Employees & dependents2,762
Total Users2,762
Operational date: April 1985.
Service area: Rhode Island: city of Providence.
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
Specialists2
Users: Group Health
Employees & dependents1,100
Total Users1,100
Service area: Rhode Island: Northeastern region.
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
Specialists16
Hospitals1
Users: Group Health
Single/family coverage1,169
Employees & dependents2,688
Total Users2,688
Operational date: January 1991.
Service Area: Rhode Island: Bristol, Kent, Newport, Providence and Washington 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
Specialists16
Hospitals1
Users: Workers Compensation
Single coverage9,115
Total Users9,115
Operational date: January 1991.
Service area: Rhode Island: Bristol, Kent, Newport, Providence and Washington counties.
See USA Workers' Injury Network consolidated listing under Texas.
United HealthCare Insurance Co.
1 Research Drive, Westborough, Mass. 01581; 508-389-7999;
fax: 508-389-7945
Staff/Facilities
Primary practitioners588
Board-certified31%
Specialists1,067
Hospitals10
Pharmacies355
Users:
Employer/payer groups165
Total Users4,067
Operational date: January 1983.
Service area: Rhode Island: Bristol, Kent, Newport, Providence and Washington counties.
Services: General medical, prescription drug, mental health/substance abuse.
Contact: James Moniz, vp-sales/marketing.
See United HealthCare Corp. PPO consolidated listing under Minnesota.
United HealthCare
of New England Inc.
475 Kilvert St., Warwick, R.I. 02886-1392; 401-737-6900; fax: 401-732-7211
Staff/Facilities
Primary practitioners2,820
Specialists4,901
Hospitals45
Pharmacies351
Users
Employer/payer groups4,700
Total Users72,909
Operational date: January 1983.
Federally qualified.
Licensed in: Massachusetts, Rhode Island.
NCQA fully accredited.
Model type: IPA.
Service area: Massachusetts: Barnstable, Bristol, Norfolk, Plymouth and Worcester counties. Rhode Island: Bristol, Kent, Newport, Providence and Washington counties.
Services: General medical, prescription drug.
Rating options: Community rating; adjusted community rating, experience rating.
Offers self-insured products.
Contact: James Moniz, vp-sales/marketing.
See United HealthCare Corp. HMO consolidated listing under Minnesota.