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1997 DIRECTORY OF MANAGED CARE PROVIDERS

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

Massachusetts
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities
Primary practitioners1,588
Specialists4,127
Hospitals26
Users
Employees & dependents111,219
Operational date: April 1991.
Service area: Massachusetts: Barnstable, Berkshire, Bristol, Dukes, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester 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 practitioners3
Hospitals3
Service area: Massachusetts: Bristol, Middlesex and Norfolk counties.
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 practitioners576
Specialists2,670
Hospitals29
Users: Group Health
Single coverage9,632
Family coverage37,691
Employees & dependents96,322
Users: Workers Compensation
Single coverage9,577
Total Users105,899
Operational date: 1991.
Service area: Massachusetts: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties.
See Beech Street Corp. consolidated listing under California.
Blue Care Elect
100 Summer St., Boston, Mass. 02110; 617-832-5000; fax: 617-832-7677
Staff/Facilities
Primary practitioners4,155
Patients/practitioner33
Specialists8,152
Hospitals83
Pharmacies1,100
Users: Group Health
Employer/payer groups367
Single coverage34,529
Family coverage37,950
Employees & dependents137,445
Ownership: Blue Cross & Blue Shield of Massachusetts.
Operational date: September 1989.
Not for profit.
AAHC/URAC accreditation status: Health Utilization Management Standards.
Service area: Massachusetts: statewide.
Contracts with Merck Medco for prescription drug in Massachusetts.
Services: General medical, prescription drug, mental health, chiropractic. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures excluding length of stay determination, retrospective review and hospital bill audits. UR provided by the PPO.
Officers: William Van Faasen, president/CEO; Gary St. Halaire, CFO; Michael Manning, treasurer; Sandra Carter, general counsel.
Contact: Phyllis Baron.
CNA Managed Care-Eastern Massachusetts
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Primary practitioners949
Specialists2,146
Hospitals32
Primary care locations36Service area: Massachusetts: Eastern Massachusetts.
See CNA Managed Care POS consolidated listing under Illinois.
CNA Managed Care-Eastern Massachusetts
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners10,579
Hospitals55
Service area: Massachusetts: Eastern Massachusetts.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Western Massachusetts
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners546
Hospitals3
Service area: Massachusetts: Western Massachusetts.
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 practitioners35
Service area: Massachusetts: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare of Massachusetts-Boston
Three Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners1,648
Board-certified82%
Patients/practitioner19.8
Specialists3,691
Hospitals37
Pharmacies*1,104
Users
Employer/payer groups609
Total32,635Operational date: January 1991.
Licensed in: Massachusetts.
NCQA one year accredited.
Model type: IPA.
Service area: Massachusetts: Barnstable, Bristol, Essex, Middlesex, Norfolk, Plymouth and Suffolk counties.
Point-of-service contracts: 62% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Brian Wells, general manager; Dr. Imre Toth, medical director; Carla Bettano, provider relations manager; Donna McCabe, quality assurance manager; Yvonne Menzloan, UM health services manager
Contact: Merry Sampson.
**Statewide total.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Massachusetts-Springfield
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners243
Board-certified81%
Patients/practitioner50.7
Specialists611
Hospitals6
Pharmacies*1,104
Users
Employer/payer groups299
Total12,338Operational date: January 1986.
Licensed in: Massachusetts.
NCQA one year accredited.
Model type: IPA.
Service area: Massachusetts: Franklin, Hampden and Hampshire counties.
Point-of-service contracts: 71.5% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Brian Wells, general manager; Dr. Imre Toth, medical director; Carla Bettano, provider relations manager; Donna McCabe, quality assurance manager; Yvonne Menzloan, UM health services manager.
Contact: Merry Sampson.
**Statewide total.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Massachusetts-Worcester
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners309
Board-certified65%
Patients/practitioner14.1
Specialists664
Hospitals9
Pharmacies*1,104
Users
Employer/payer groups301
Total4,368Operational date: January 1989.
Licensed in: Massachusetts.
NCQA one year accredited.
Model type: IPA.
Service area: Massachusetts: Worcester County.
Point-of-service contracts: 66.5% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Brian Wells, general manager; Dr. Imre Toth, medical director; Carla Bettano, provider relations manager; Christine Bamforth, quality assurance manager; Yvonne Menzloan, UM health services manager.
Contact: Merry Sampson.
**Statewide total.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Boston
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners1,716
Board-certified83.7%
Patients/practitioner21.3
Specialists3,016
Hospitals47
Users: Group Health
Employer/payer groups439
Total Users36,621
Operational date: July 1995.
Service area: Massachusetts: Barnstable, Bristol, Essex, Middlesex, Norfolk, Plymouth and Suffolk 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.
CIGNA PPO-Springfield/Worcester
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners434
Board-certified78.7%
Patients/practitioner15.2
Specialists1,085
Hospitals18
Users: Group Health
Employer/payer groups222
Total Users6,615
Operational date: April 1992.
Service area: Massachusetts: Franklin, Hampden, Hampshire and Worcester 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 practitioners1,008
Board-certified95%
Specialists3,506*
Hospitals52
Service area: Massachusetts.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.