1997 DIRECTORY OF MANAGED CARE PROVIDERS ( TEXAS)
Posted On: Dec. 28, 1997 12:00 AM CSTCIGNA HealthCare of Texas Inc.-Austin
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners134
Board-certified51.9%
Patients/practitioner16.6
Specialists275
Hospitals10
Pharmacies*1,159
Users
Employer/payer groups161
Total2,226Operational date: June 1996.
Licensed in: Texas
Model type: IPA.
Service area: Texas: Bastrop, Travis and Williamson counties.
Point-of-service contracts: 49.7% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Patrick Stewart, Healthplan president; Dr. John J. Siedenfield, medical director; Paula McHam, director/manager-operations; Andy Trainer, pharmacy director; Robert Kneppler, sales director/manager.
Contact: Renee Wilson.
**Figure represents total pharmacies for Austin, Corpus Christi, East Texas, Golden Triangle, Houston and San Antonio operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-Corpus Christi/Coastal Bend
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners101
Board-certified58.3%
Patients/practitioner52.7
Specialists190
Hospitals10
Pharmacies*1,159
Users
Employer/payer groups65
Total5,331Operational date: January 1996.
Licensed in: Texas.
Model type: IPA.
Service area: Texas: Aransas, Bee, Colorado, Jim Wells, Kleberg, Nueces and San Patricio counties.
Point-of-service contracts: 17.6% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Partick Stewart, Healthplan president; Dr. John J. Siedenfeld, medical director; Paula McHam, director/manager-operations; Andy Trainer, pharmacy director;
Robert Kneppler, sales director/market manager.
Contact: Renee Wilson.
**Figure represents total pharmacies for Austin, Corpus Christi, East Texas, Golden Triangle, Houston and San Antonio operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-East Texas/Lufkin
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners43
Board-certified54.3%
Patients/practitioner217.9
Specialists95
Hospitals6
Pharmacies*1,159
Users
Employer/payer groups62
Total9,372Operational date: July 1995.
Licensed in: Texas.
Model type: IPA.
Service area: Texas: Anderson, Angelina, Cherokee, Houston, Jasper, Nacogdoches, Newton, Polk, Sabine, San Augustine, Shelby, Trinity and Tyler counties.
Point-of-service contracts: 98.6% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Partick Stewart, Healthplan president; Dr. John J. Seidenfeld, medical director; Paula McHam, director/manager-operations; Andy Trainer, pharmacy director;
Robert Kneppler, sales director/market manager.
Contact: Renee Wilson.
**Figure represents total pharmacies for Austin, Corpus Christi, East Texas, Golden Triangle, Houston and San Antonio operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-Golden Triangle
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners215
Board-certified58.4%
Patients/practitioner132.9
Specialists344
Hospitals11
Pharmacies*1,159
Users
Employer/payer groups125
Medicare309
Total28,899Operational date: January 1995.
Licensed in: Texas.
Model type: Group/IPA/Staff.
Service area: Texas: Hardin, Jasper, Jefferson Newton and Orange counties.
Point-of-service contracts: 76.2% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Partick Stewart, Healthplan president; Dr. John J. Seidenfeld, medical director; Paula McHam, director/manager-operations; Andy Trainer, pharmacy director;
Robert Kneppler, sales director/market manager.
Contact: Renee Wilson.
**Figure represents total pharmacies for Austin, Corpus Christi, East Texas, Golden Triangle, Houston and San Antonio operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-Houston
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners833
Board-certified66.4%
Patients/practitioner147
Specialists3,197
Hospitals59
Pharmacies*1,159
Users
Employer/payer groups938
Medicare336
Total122,826Operational date: July 1982.
Licensed in: Texas.
NCQA one year accredited.
Model type: Group/IPA/Staff.
Service area: Texas: Austin, Brazoria, Chambers, Fort Bend, Galveston, Grimes, Harris, Liberty, Matagorda, Montgomery, San Jacinto, Walker, Waller and Wharton counties.
Point-of-service contracts: 56.2% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Partick Stewart, Healthplan president; Dr. John J. Seidenfeld, medical director; Paula McHam, director/manager-operations; Andy Trainer, pharmacy director;
Robert Kneppler, sales director/market manager.
Contact: Renee Wilson.
**Figure represents total pharmacies for Austin, Corpus Christi, East Texas, Golden Triangle, Houston and San Antonio operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-North Texas
600 E. Las Colinas Blvd., Suite 1100, Irving, Texas 75039; 972-401-5200; fax: 214-401-5399
Staff/Facilities
Primary practitioners707
Board-certified84%
Patients/practitioner219.4
Specialists1,858
Hospitals48
Pharmacies*1,094
Users
Employer/payer groups662
Total155,151Operational date: March 1980.
Licensed in: Texas.
NCQA fully accredited.
Model type: Group/IPA/Staff.
Service area: Texas: Collin, Dallas, Denton, Ellis, Fannin, Grayson, Henderson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant and Wise counties.
Point-of-service contracts: 49% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Anthony Van Roekel, general manager; Dr. David Seeley, medical director; Mark Edwards, director-provider relations; Melanie Sanders, quality assurance manager; Emma Thomas Hay, UM health services manager.
Contact: Carol Rodriguez.
**Figure represents total pharmacies for North Texas and Tyler operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-San Antonio
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners158
Board-certified73.8%
Patients/practitioner23.7
Specialists415
Hospitals15
Pharmacies*1,159
Users
Employer/payer groups127
Total3,747Operational date: May 1996.
Licensed in: Texas.
Model type: IPA.
Service area: Texas: Atascosa, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson counties.
Point-of-service contracts: 38.6% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Partick Stewart, Healthplan president; Dr. John J. Seidenfeld, medical director; Paula McHam, director/manager-operations; Andy Trainer, pharmacy director;
Robert Kneppler, sales director/market manager.
Contact: Renee Wilson.
**Figure represents total pharmacies for Austin, Corpus Christi, East Texas, Golden Triangle, Houston and San Antonio operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Texas Inc.-Tyler
600 E. Las Colinas Blvd., Suite 1000, Irving, Texas 75039; 800-238-8801; fax: 972-401-5399
Staff/Facilities
Primary practitioners75
Board-certified78.6%
Patients/practitioner50.4
Specialists144
Hospitals2
Pharmacies1,094
Users
Employer/payer groups63
Total3,787Operational date: January 1995.
Licensed in: Texas.
Model type: IPA.
Service area: Texas: Smith, Van Zandt and Wood counties.
Point-of-service contracts: 83.3% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Anthony Van Roekel, general manager; Dr. David Seeley, medical director; Bob Nolen, pharmacy director; Mark Edwards, director-provider relations; Paul Carter-government programs director/manager.
Contact: Carol Rodriguez.
**Figure represents total pharmacies for North Texas and Tyler operations.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Beaumont/Port Arthur
2 Riverway, Suite 1200, Houston, Texas 77056; 800-238-8801; fax: 713-552-7828
Staff/Facilities
Primary practitioners172
Board-certified59.8%
Patients/practitioner21.3
Specialists286
Hospitals17
Users: Group Health
Employer/payer groups69
Total Users3,672
Operational date: July 1994.
Service area: Texas: Chambers, Hardin, Jasper, Jefferson, Newton and Orange counties.
Officers: Partick Stewart, health plan president; Dr. John J. Seidenfeld, medical director; Paula McHam, director/manager-operations; Robert Kneppler, sales director/market manager; Brad Arms, regional managed care officer.
Contact: Michael C. Kelly, 860-726-3794.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Corpus Christi/Costal Bend
2 Riverway, Suite 1200, Houston, Texas 77056; 713-552-7600; fax: 713-552-7828
Staff/Facilities
Primary practitioners95
Board-certified59.8%
Patients/practitioner37.8
Specialists175
Hospitals10
Users: Group Health
Employer/payer groups41
Total Users3,599
Operational date: January 1996.
Service area: Texas: Aransas, Bee, Colorado, Jim Wells, Kleberg, Nueces and San Patricio counties.
Officers: Partick Stewart, health plan president; Dr. John J. Seidenfeld, medical director; Paula McHam, director/manager-operations; Robert Kneppler, sales director/market manager; Brad Arms, regional managed care officer.
Contact: Michael C. Kelly, 860-726-3794.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Houston
2 Riverway, Suite 1200, Houston, Texas 77056; 800-238-8801; fax: 713-552-7828
Staff/Facilities
Primary practitioners1,181
Board-certified70.3%
Patients/practitioner70.9
Specialists2,632
Hospitals58
Users: Group Health
Employer/payer groups487
Total Users83,818
Operational date: January 1988.
Service area: Texas: Austin, Brazoria, Brazos, Chambers, Fort Bend, Galveston, Grimes, Harris, Liberty, Matagorda, Montgomery, San Jacinto, Walker, Waller and Wharton counties.
Officers: Partick Stewart, health plan president; Dr. John J. Seidenfeld, medical director; Robert Kneppler, sales director/market manager; Paula McHam, director/manager-operations; Donna Jennings, regional contracting officer.
Contact: Michael C. Kelly, 860-726-3794.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-North Texas/Dallas
600 E. Las Colinas Blvd., Suite 1100, Irving, Texas 75039; 214-401-5200; fax: 214-401-5399
Staff/Facilities
Primary practitioners804
Board-certified87.3%
Patients/practitioner75.1
Specialists2,393
Hospitals54
Users: Group Health
Employer/payer groups565
Total Users60,427
Operational date: January 1988.
Service area: Texas: Collin, Dallas, Denton, Ellis, Fannin, Grayson, Henderson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant and Wise counties.
Officers: Joanna Robben, assistant vp-network management; Anthony Van Roekel, general manager; Dr. David Seeley, medical director; Brad Arms, regional managed care officer; Mark Edwards, director-provider relations.
Contact: Michael C. Kelly, 860-726-3794.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Tyler
600 E. Las Colinas Blvd., Suite 1100, Irving, Texas 75039; 800-238-8801; fax: 214-401-5399
Staff/Facilities
Primary practitioners76
Board-certified79.2%
Patients/practitioner12.7
Specialists145
Hospitals4
Users: Group Health
Employer/payer groups59
Total Users968
Operational date: January 1995.
Service area: Texas: Smith, Van Zandt and Wood counties.
Officers: Joanna Robben, assistant vp-network management; Anthony Van Roekel, general manager; Dr. David Seeley, medical director; Brad Arms, regional managed care officer; Bob Nolen, pharmacy director.
Contact: Michael C. Kelly, 860-726-3794.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CORPHEALTH Inc.
1300 Summit Ave., Suite 600, Fort Worth, Texas 76102; 817-332-2519; fax: 817-335-9100
Specialty: mental health
Staff/Facilities
Primary practitioners30,000
Hospitals3,000
Users: Group Health
Employees & dependents1,000,000
Total Users1,000,000
Operational date: 1987.
For profit.
AAHC/URAC accreditation status: Health Utilization Management Standards.
Service area: Nationwide.
Services: Mental health, substance abuse. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers, insurers; charges flat fee per employee.
UR: Standard procedures excluding retrospective review, second surgical opinion and hospital bill audits. UR provided by the PPO.
Officers: Patrick D. Gotcher, president/CEO; David L. Redfield, COO; Michael G. Baker, CFO; Dr. Ken Hopper, medical director; Robert Cull, senior vp-operations.
Contact: Paul J. Floyd, senior vp.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners6,586
Board-certified90%
Specialists21,194*
Hospitals400
Service area: Texas.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.