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1997 DIRECTORY OF MANAGED CARE PROVIDERS

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

Utah
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners449
Specialists921
Hospitals21
Service area: Utah: 24 counties.
Services: General medical, mental health, workers compensation, ancillary services.
See CCN consolidated listing under California.
CNA Managed Care
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners2,351
Hospitals16
Service area: Utah.
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 practitioners80
Service area: Utah: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare of Utah Inc.
5295 South 320 West, Suite 280, Salt Lake City, Utah; 801-265-2777; 801-261-5349
Staff/Facilities
Primary practitioners334
Board-certified80.2%
Patients/practitioner93.8
Specialists853
Hospitals12
Pharmacies356
Users
Employer/payer groups98
Total31,356Operational date: January 1985.
Licensed in: Utah.
NCQA fully accredited.
Model type: IPA.
Service area: Utah: Box Elder, Davis, Juab, Millard, Morgan, Salt Lake, Sanpete, Sevier, Summit, Tooele, Utah, Wasatch and Weber counties.
Point-of-service contracts: 52.1% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Robert Immitt, general manager/executive director; Dr. John Tudor, medical director; Lynette Hansen, quality assurance manager; Debbie McNamara, UM health services manager; Martha Spoor, member services manager.
Contact: Kapil Soorma.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Salt Lake City
5295 South 320 West, Suite 280, Salt Lake City, Utah; 801-265-2777; 801-261-5349
Staff/Facilities
Primary practitioners293
Board-certified80.6%
Patients/practitioner33.3
Specialists715
Hospitals18
Users: Group Health
Employer/payer groups229
Total Users9,772
Operational date: January 1991.
Service area: Utah: Box Elder, Davis, Juab, Kane, Millard, Morgan, Salt Lake, Sanpete, Sevier, Summit, Tooele, Utah, Wasatch and Weber counties.
Officers: Robert Immitt, executive director/general manager; Brad Arms, regional managed care officer; Dr. John Tudor, medical director; Pascale de Rozario, 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 practitioners498
Board-certified90%
Specialists1,712*
Hospitals35
Service area: Utah.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
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 practitioners1,009
Specialists2,904
Hospitals19
Total Users20,289
Operational date: August 1996.
Service area: Idaho: Bannock and Oneida counties; Utah: 23 counties.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*812
Specialists1,167
Hospitals**18
Service area: Utah: 24 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Healthwise
2455 Parley's Way, Salt Lake City, Utah 84109; 801-481-6441; fax: 801-481-6994
Staff/Facilities
Primary practitioners520
Board-certified90%
Patients/practitioner41
Specialists1,981
Hospitals22
Users
Employer/payer groups193
Single coverage1,191
Family coverage7,595
Employees & dependents25,869
Medicaid9,162
Total35,031
Revenues
First-half 1997$23,700,183
1996$35,730,924Parent: Regence Blue Cross & Blue Shield of Utah.
Operational date: September 1982.
Federally qualified.
Licensed in: Utah.
Model type: Network.
For profit.
Service area: Utah: Davis, Morgan, Tooele, Utah and Weber counties.
Member of HMO Blue USA.
Services: General medical, dental, vision, prescription drug. Services available unbundled. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Non-federally qualified programs.
Officers: Jed H. Pitcher, chairman/president/CEO; Michael Emmett Tobin, vice chairman/secretary; Russell Paul Warburton, CFO/treasurer; Neal Anthony Spero, senior vp-marketing; Todd D. Trettin, senior vp-actuarial services.
Contact: Russell Paul Warburton, 801-481-6614.
Intergroup of Utah Inc.
127 S. 500 East, Suite 510, Salt Lake City, Utah 84102; 801-532-7665;
fax: 801-297-4585
Staff/Facilities
Primary practitioners583
Board-certified98%
Patients/practitioner17
Specialists1,162
Hospitals16
Pharmacies237
Primary care locations186
Users
Employer/payer groups237
Single coverage1,542
Family coverage2,339
Employees & dependents10,156
Total10,156Parent: Foundation Health Systems Inc.
Operational date: March 1994.
Licensed in: Utah.
Model type: IPA.
Service area: Utah: 22 counties.
Services: General medical, dental, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating; community rating by class.
Offers self-insured products.
Officers: Ed Munno, president; Debby Moore, director-plan administration; Cindy Weeks, vp-finance; Dr. E. Douglas Slawson, medical director; Gregory S. Schmidt, director-marketing/sales.
Contact: Linnea Bentz, account executive, 801-532-7665.
See Foundation Health Systems consolidated HMO/POS listing under California.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners*NA
Specialists*NA
Hospitals9
Users: Group Health
Employer/payer groups7
Employees & dependents103,750
Service area: Utah: Cache, Carbon, Davis, Iron, Juab, Kane, Salt Lake, Sanpete, Uintah, Utah, Washington, Wayne and Weber 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 practitioners14
Service area: Utah: cities of American Fork, Ogden, Payson, Provo, Richfield, Salt Lake City, Sandy and St. George.
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 practitioners771
Specialists1,958
Hospitals18
Users: Group Health
Employer/payer groups13
Employees & dependents16,631
Total Users16,631
Service area: Utah.
See National Preferred Provider Network Inc. consolidated listing under New York.
PacifiCare of Utah
35 W. Broadway, Salt Lake City, Utah 84101; 801-355-1234; fax: 801-933-3682
Staff/Facilities
Primary practitioners708
Board-certified78.4%
Specialists1,684
Hospitals18
Pharmacies280
Users
Employer/payer groups938
Single/family coverage50,800
Employees & dependents157,056
Medicare14,167
Medicaid12,851
Total186,114
Revenues
First-half 1997$133,132,424
1996$233,684,552Operational date: January 1976.
Federally qualified.
Licensed in: Utah.
NCQA one year accredited.
Model type: Group/IPA.
Service area: Utah: Box Elder, Cache, Davis, Morgan, Salt Lake, Summit, Tooele, Utah, Washington, Wasatch and Weber counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class.
Point-of-service contracts: 20% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual is enrollment allowed.
Officers: Chris Wing, president; Dr. John Vinton, medical director; Brent Haslam, vp-marketing/sales; Joseph DeVita, CFO/vp-finance; Tim Vest, vp-operations.
See PacifiCare Health Systems HMO/POS consolidated listing under California.
PacifiCare of Utah
35 W. Broadway, Salt Lake City, Utah 84101; 801-355-1234; fax: 801-933-3682
Staff/Facilities
Primary practitioners708
Specialists1,684
Hospitals18
Pharmacies280
Users
Employer/payer groups429
Single/family coverage4,971
Employees & dependents15,423
Ownership: PacifiCare Health Systems.
Operational date: April 1991.
For profit.
Service area: Utah: Box Elder, Cache, Davis, Morgan, Salt Lake, Utah, Washington and Weber counties.
Services: General medical, dental, vision, prescription drug, 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, percent of fee schedule, capitation; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures. UR provided by the PPO.
Officers: Chris Wing, president; Dr. John Vinton, medical director; Brent Haslam, vp-marketing/sales; Joseph DeVita, CFO/vp-finance; Tim Vest, vp-operations.
Premier Medical Network
420 E. South Temple, Suite 300, Salt Lake City, Utah 84111-1309; 800-777-7572; fax: 801-530-7254
Staff/Facilities
Primary practitioners643
Board-certified95%
Specialists1,215
Hospitals21
Users: Group Health
Employer/payer groups761
Employees & dependents25,960
Users: Workers Compensation
Single coverage38,022
Total Users63,982
Ownership: Columbia/HCA.
Operational date: August 1995.
For profit.
Service area: Utah: Beaver, Box Elder, Cache, Carbon, Davis, Iron, Juab, Millard, Morgan, Salt Lake, Sanpete, Sevier, Summit, Tooele, Uintah, Utah, Wasatch, Washington, Wayne and Weber counties.
Services: General medical, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers; charges flat fee per employee, by percent of savings.
UR: Standard procedures excluding second surgical opinion, hospital bill audits. UR provided by the PPO.
Officers: Kurt Fullmer, vp; John Oaks, director-operations; Richard Jensen, director-sales, JoAnne Allen, manager-medical services; Dr. Kenneth Schecher, medical director.
Contact: Ricard Jensen.
Private Healthcare Systems Inc.
650 S. Cherry St., Suite 1050, Denver, Colo. 80222; 303-399-1903;
fax: 303-399-2369
Staff/Facilities
Primary practitioners401
Board-certified82%
Specialists330
Hospitals16
Pharmacies341
Users
Employees & dependents2,116
Total2,116Service Area: Utah: cities of Ogden, Orem, Provo and Salt Lake City.
See Private Healthcare Systems POS consolidated listing under Massachusetts.
Private Healthcare Systems
650 S. Cherry St., Suite 1050, Denver, Colo. 80222; 303-399-1903; fax: 303-399-2369
Staff/Facilities
Primary practitioners1,041
Board-certified82%
Specialists1,234
Hospitals16
Pharmacies341
Users: Group Health
Employees & dependents67,503
Total Users67,503
Operational date: May 1987.
Service area: Utah: cities of Ogden, Orem, Provo and Salt Lake City.
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 practitioners88
Specialists154
Hospitals6
Users: Group Health
Employees & dependents4,500
Total Users4,500
Service area: Utah: 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 practitioners6
Specialists117
Hospitals7
Users: Group Health
Single/family coverage3,236
Employees & dependents7,443
Total Users7,443
Operational date: August 1989.
Service Area: Utah: Box Elder, Cache, Carbon, Davis, Grand, Iron, Kane, Salt Lake, Sanpete, Tooele, Uintah, Utah, Wasatch, Washington and Weber 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 practitioners2
Specialists118
Hospitals7
Users: Workers Compensation
Single coverage44,209
Total Users44,209
Operational date: August 1989.
Service area: Utah: Box Elder, Cache, Carbon, Davis, Grand, Iron, Kane, Salt Lake, Sanpete, Tooele, Uintah, Utah, Wasatch, Washington and Weber counties.
See USA Workers' Injury Network consolidated listing under Texas.
United HealthCare
of Utah
7910 South 3500 East, Salt Lake City, Utah 84121-0409; 801-942-6200; fax: 801-942-0415
Staff/Facilities
Primary practitioners721
Specialists2,391
Hospitals11
Pharmacies300
Total Users121,176
Licensed in: Utah.
Model type: Network.
Service area: Utah: Box Elder, Carbon, Davis, Duchesne, Emery, Morgan, Salt Lake, Summit, Tooele, Uintah, Utah, Wasatch and Weber counties.
Services: General medical, prescription drug, mental health/substance abuse.
Offers self-insured products.
Contact: Craig Frazer, vp-sales/marketing.
See United HealthCare Corp. HMO consolidated listing under Minnesota.
United HealthCare Insurance Co.
7910 South 3500 East, Salt Lake City, Utah 84121-0409; 801-942-6200;
fax: 801-942-0415
Staff/Facilities
Primary practitioners1,464
Board-certified51%
Specialists2,943
Hospitals11
Pharmacies300
Users:
Employer/payer groups353
Total Users17,991
Service area: Utah: Box Elder, Carbon, Davis, Duchesne, Emery, Morgan, Salt Lake, Summit, Tooele, Uintah, Utah, Wasatch and Weber counties.
Services: General medical, prescription drug, mental health/substance abuse.
Contact: Craig Frazer, vp-sales/marketing.
See United HealthCare Corp. PPO consolidated listing under Minnesota.
Valuecare
2455 Parley's Way, P.O. Box 25956, Salt Lake City, Utah; 801-481-6179; fax: 801-481-6994
Staff/Facilities
Primary practitioners925
Board-certified90%
Patients/practitioner120
Specialists1,675
Hospitals30
Pharmacies360
Users: Group Health
Employer/payer groups1,175
Single/family coverage38,339
Employees & dependents110,443
Users: Workers Compensation
Employer/payer groups10
Single coverage30,400
Ownership: Regence Blue Cross & Blue Shield of Utah.
Operational date: October 1984.
For profit.
Service area: Utah: 27 counties.
Services: General medical, dental, mental health, chiropractic. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, DRGs; is compensated by employers/payers; charges flat fee per employee, by percent of paid claims.
UR: Standard procedures. UR provided by the PPO.
Officers: Jed H. Pitcher, chairman/president/CEO; Michael E. Tobin, executive vp/COO; Neal A. Spero, senior vp-marketing; Todd D. Trettin, senior vp-actuarial/rating/provider reimbursement; Dr. S. Keith Petersen, vp-managed care/medical policy/medical director.
Contact: Michael E. Tobin.