1997 DIRECTORY OF MANAGED CARE PROVIDERS
Posted On: Dec. 28, 1997 12:00 AM CSTColorado
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities*
Primary practitioners11,446
Specialists3,194
Hospitals40
Users
Employees & dependents173,987
Operational date: June 1988.
Service area: Colorado: 44 counties.
**Includes leased providers/facilities.
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 practitioners15
Hospitals4
Service area: Colorado: Adams, Arapahoe, Denver, Douglas, El Paso, Fremont, Jefferson and Teller counties.
See AnciCare PPO consolidated listing under Florida.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners1,000
Specialists2,645
Hospitals22
Service area: Colorado: 45 counties.
Services: General medical, mental health, workers compensation, ancillary services.
See CCN consolidated listing under California.
CNA Managed Care-Denver
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Primary practitioners671
Specialists1,507
Hospitals14
Primary care locations15Service area: Colorado: Denver.
See CNA Managed Care POS consolidated listing under Illinois.
CNA Managed Care-Denver
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners5,442
Hospitals33
Service area: Colorado: Denver.
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 practitioners1,503*
Board-certified47.1%
Patients/practitioner13.4
Hospitals17
Service area: Colorado: 38 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 practitioners27
Service area: Colorado: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare of Colorado Inc.
3900 E. Mexico Ave., Suite 1100, Denver, Colo. 80210; 303-782-1500; fax: 303-782-1577
Staff/Facilities
Primary practitioners892
Board-certified84%
Patients/practitioner129.2
Specialists2,789
Hospitals24
Pharmacies592
Users
Employer/payer groups1,018
Medicare4,054
Total119,307Operational date: July 1986.
Licensed in: Colorado.
NCQA fully accredited.
Model type: IPA.
Service area: Colorado: Adams, Arapahoe, Boulder, Denver, Douglas, El Paso, Jefferson, Larimer, Pueblo, Teller and Weld counties.
Point-of-service contracts: 48.8% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Diana Mariani, assistant vp-Healthplan operations; Daryl Edmonds, general manager; Dr. Vernon Walters, medical director; Doug Wilson, sales director/manager; Kathy Gies, UM health services manager/quality assurance manager.
Contact: Mike Posey.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Colorado
3900 E. Mexico Ave., Suite 1000, Denver, Colo. 80210; 303-782-1500; fax: 303-782-1577
Staff/Facilities
Primary practitioners1,035
Board-certified82.3%
Patients/practitioner40.6
Specialists2,858
Hospitals27
Users: Group Health
Employer/payer groups450
Total Users42,104
Operational date: May 1991.
Service area: Colorado: Adams, Arapahoe, Boulder, Denver, Douglas, Eagle, El Paso, Jefferson, Larimer, Logan, Pueblo, Summit, Teller and Weld counties.
Officers: Daryl Edwards, general manager; Dr. Vernon Walters, medical director; Mike Posey, planning/analysis-medical economics; Doug Wilson, sales director/manager.
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 practitioners1,529
Board-certified92%
Specialists6,470*
Hospitals47
Service area: Colorado.
**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 practitioners480
Specialists4,126
Hospitals12
Total Users15,780
Operational date: September 1990.
Service area: Colorado: 39 counties.
**Includes leased providers/facilities.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
Great-West Life POS/The New England POS
8505 E. Orchard Road, Englewood, Colo. 80111; 303-689-3000; fax: 303-689-3198
Staff/Facilities
Primary practitioners51,962
Specialists147,397
Hospitals1,600
Pharmacies53,244
Users
Employer/payer groups1,851
Employees & dependents324,934
Total324,934Parent: Great-West Life & Annuity Insurance Co.
Operational date: January 1990.
Model type: IPA.
For profit.
Service area: Alabama, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.
Services: General medical, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Offers self-insured products.
Officers: William McCallum, president/CEO; Jim Motz, executive vp-employee benefits; Marty Rosenbaum, senior vp-employee benefits operations; Steve Miller, senior vp-group sales; Dr. Steve M. Gorshow, medical director-employee benefits.
Contact: Michelle Keel, 303-689-5135.
Great-West Life & Annuity Insurance Co. is a shareholder in the Private Healthcare Systems POS network.
Great-West Life PPO/The New England PPO
8505 E. Orchard Road, Englewood, Colo. 80111; 303-689-5135; fax: 303-689-5760
Staff/Facilities
Primary practioners*286,019
Hospitals2,772
Pharmacies**53,244
Users
Employees & dependents1,022,226
Total Users1,022,226
Ownership: Great-West Life & Annuity Insurance Co.
Operational date: September 1984.
For profit.
Service area: Nationwide, excluding Delaware, Vermont and Wyoming.
Contracts with American Lifecare in Mississippi; Center Care in Kentucky; Coastal HealthCare in California; Ethix Great Lakes in Michigan; Ethix Northwest in Alaska, Montana, Washington; Ethix Pacific in Oregon; Ethix Southwest in North Carolina; Florida First Preferred in Florida; Health First in Iowa; Health Net in Tennessee; Health Partners Health Plans Inc. in Arizona; HealthChoice of Connecticut in Connecticut; Managed HealthCare Northwest in Oregon; Medical Network (Med Net) in Maine; National Capital PPO in the District of Columbia; Network Health Plan in Wisconsin; One Source Health Network/Premier Medical Network in Utah; PPO Alliance in California; Plaines Health Networks in Iowa; Preferred Health Partnership in Tennessee; Preferred One Northern Michigan in Michigan; PreferredOne in Minnesota; Preferred Plan of Indiana in Indiana; Preferred Plan of Nebraska/Iowa in Nebraska; Presbyterian Health Plan in New Mexico; St. Mary's Preferred Health Care Network in Nevada; SelectNet Plus/Primary One in West Virginia; Superior of California in California; TakeCare Preferred in North Carolina; Western Kentucky Healthcare System in Kentucky; Wisconsin Preferred Provider Network in Wisconsin.
Services: General medical, prescription drug, mental health, physical therapy. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs, combination per diem/discount; is compensated by employers/payers, insurers; charges flat fee per employee.
UR: Standard procedures, excluding hospital bill audits and outpatient service predetermination. UR provided by the PPO.
Officers: William McCallum, president/CEO; Jim Motz, executive vp-employee benefits; Marty Rosenbaum, senior vp-employee benefits operations; Steve Miller, senior vp-group sales; Dr. Steve M. Gorshow, medical director-employee benefits.
Contact: Michelle Keel.
**Includes specialists.
***As of Oct. 2, 1997.
Great-West Life & Annuity Insurance Co. is a shareholder in the Private Healthcare Systems PPO network.
Health Management Network
1600 W. Broadway Road, Suite 385, Tempe, Ariz. 85282; 602-921-8944;
fax: 602-894-5230
Staff/Facilities
Primary practitioners457
Board-certified82%
Specialists1,355
Hospitals37
Users: Group Health
Employer/payer groups27
Single coverage4,700
Family coverage5,100
Employees & dependents22,100
Users: Workers Compensation
Employer/payer groups2
Single coverage700
Total Users22,800
Service area: Colorado.
See Health Management Network consolidated listing under Arizona.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*1,784
Specialists2,526
Hospitals**48
Service area: 53 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Kaiser Foundation Health Plan
of Colorado
2500 S. Havana St., Aurora, Colo. 80014; 303-338-3700; fax: 303-338-3707
Staff/Facilities
Primary practitioners294
Board-certified97%
Patients/practitioner467
Specialists228
Hospitals9
Pharmacies15
Primary care locations15
Users
Employer/payer groups4,310
Single coverage97,097
Family coverage79,363
Employees & dependents297,954
Medicare38,645
Medicaid4,994
Total337,025Operational date: July 1969.
Federally qualified.
Licensed in: Colorado.
NCQA fully accredited.
Model type: Group.
Service area: Colorado: Adams, Arapahoe, Boulder, Clear Creek, Denver, Douglas, Elbert, Gilpin, Grand, Jefferson, Larimer, Park and Weld counties.
Services: General medical, vision, prescription drug, mental health, durable medical equipment, hospitalization, lab, X-ray, preventive medicine, health education, substance abuse. 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: 1% of members are enrolled.
Officers: Kathryn A. Paul, president; Dr. Toby Cole, medical group director-Colorado Permanente Medical Group; Dr. William R. Marsh, associate medical director-operations; R. Michael Alexander, vp/executive director; E. Duane Eason, vp/manager-financial services.
Contact: Suzanne M. Bessette, 303-338-3758.
See Kaiser Permanente consolidated listing under California.