1997 DIRECTORY OF MANAGED CARE PROVIDERS

Louisiana
Advantage Blue
5525 Reitz Ave., Baton Rouge, La. 70809; 504-295-3307; fax: 504-295-2054
Staff/Facilities
Primary practitioners1,068
Board-certified68%
Patients/practitioner25
Specialists1,847
Hospitals41
Primary care locations433
Users
Employer/payer groups5,087
Single coverage2,245
Family coverage1,313
Employees & dependents10,028
Total10,028
Revenues
First-half 1997$4,554,575
1996$2,530,098Parent: Louisiana Health Service & Indemnity Co. Inc. dba Blue Cross & Blue Shield of Louisiana.
Operational date: January 1994.
Licensed in: Louisiana.
Model type: Network.
Not for profit.
Service area: Louisiana: all parishes except Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union and West Carroll.
Services: General medical, prescription drug, mental health, rehabilitation, ambulatory surgery centers, durable medical equipment, home health, hospice, independent labs, outpatient surgery centers, skilled nursing facilities. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Officers: P.J. Mills, president/CEO; Paul Dykes, executive vp/chief administrative officer; Ken Bird, executive vp/chief information officer; Kathryn Sullivan, executive vp/COO; Jamus Jacobs, executive vp/chief marketing officer.
Advantage Health Plan Inc.
829 St. Charles Ave., New Orleans, La. 70130; 504-568-9009; fax: 504-568-0301
Staff/Facilities
Primary practitioners838
Board-certified70%
Patients/practitioner100
Specialists1,701
Hospitals37
Pharmacies915
Users
Employer/payer groups460
Employees & dependents74,792
Medicare9,367
Total84,159
Revenues
First-half 1997$38,466,079
1996$28,329,874Operational date: July 1994.
Licensed in: Louisiana.
Model type: Network.
For profit.
Service area: Louisiana: 52 parishes.
Contracts with Prescription Solutions for prescription drug, Denta Max for dental/vision and Family Managed Care for mental health in Louisiana.
Services: General medical.
Rating options: Community rating by class; adjusted community rating.
Point-of-service contracts: 19% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Jane Cooper, president/CEO; Drew Joyce, vp-finance; Mindy Brown, vp-medical management; Peg Wallin, vp-management services; Dr. Stan Stier, medical director.
Contact: Dan Thomas, 504-679-6603.
Advantage PPO*
829 St. Charles Ave., New Orleans, La. 70130; 504-568-9009; fax: 504-568-0301
Staff/Facilities
Primary practitioners1,207
Specialists2,629
Hospitals96
Users: Group Health
Employer/payer groups254
Employees & dependents89,035
Users: Workers Compensation
Employer/payer groups8
Single coverage20,696
Total Users109,731
Ownership: Advantage Health Plan Inc.
Operational date: June 1989.
For profit.
Service area: Louisiana, Mississippi.
Contracts with Denta Max for dental/vision and Family Managed Care for mental health in Louisiana and Mississippi.
Services: General medical. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee.
UR: Standard procedures excluding second surgical opinion and hospital bill audits. UR provided by the PPO.
Officers: James Cooper, president/CEO; Drew Joyce, vp-finance; Mindy Brown, vp-medical management; Peg Wallin, vp-management services; Dr. Stan Stier, medical director.
Contact: Dan Thomas, director-marketing, 504-679-6603.
**Figures are consolidated, including all PPO plans in this organization.
Advantage PPO
829 St. Charles Ave., New Orleans, La. 70130; 504-568-9009; fax: 504-568-0301
Staff/Facilities
Primary practitioners895
Specialists1,994
Hospitals63
Users: Group Health
Employer/payer groups181
Employees & dependents55,711
Users: Workers Compensation
Employer/payer groups7
Single coverage17,196
Total Users72,907
Service area: Louisiana: statewide.
See Advantage PPO consolidated listing under Louisiana.
American LIFECARE*
650 Poydras St., Suite 1150, New Orleans, La. 70130; 504-561-0600; fax: 504-522-5503
Staff/Facilities
Primary practitioners2,883
Specialists4,848
Hospitals165
Users: Group Health
Employees & dependents534,000
Users: Workers Compensation
Employer/payer groups80
Operational date: 1983.
For profit.
Service area: Arkansas, Louisiana, Mississippi.
Services: General medical, workers compensation**. 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, DRGs; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee, by percent of savings, by percent of services by doctors/hospitals.
UR: UR provided by the PPO.
Officers: Ed Michael Reggie, president; Kristin Hutchins, chief-operations.
Contact: Maureen Mullen.
**Figures are consolidated, including all PPO plans in this organization. ***Louisiana only.
American LIFECARE
650 Poydras St., Suite 1550, New Orleans, La. 70130; 504-561-0600; fax: 504-522-5503
Staff/Facilities
Primary practitioners1,527
Specialists2,554
Hospitals84
Users: Group Health
Employees & dependents376,000
Users: Workers Compensation
Employer/payer groups80
Service area: Louisiana: cities of Alexandria, Baton Rouge, Houma, Lafayette, Lake Charles, New Orleans, Northshore, Monroe and Shreveport.
UR: Standard procedures, excluding hospital bill audits.
See American LIFECARE consolidated listing under Louisiana.
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 practitioners9
Hospitals4
Service area: Baton Rouge, East Baton Rouge, Orleans and Vernon parishes.
See AnciCare PPO consolidated listing under Florida.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners1,034
Board-certified68.5%
Patients/practitioner45.8
Specialists3,201
Hospitals80
Users: Group Health
Employer/payer groups57
Employees & dependents45,138
Users: Workers Compensation
Employer/payer groups12
Total Users*45,138
Service area: Louisiana: 61 parishes.
Services: General medical, mental health, workers compensation, ancillary services.
**Does not include workers compensation users.
See CCN consolidated listing under California.
CCN Elect
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; fax: 619-278-1262
Staff/Facilities
Primary practitioners992
Board-certified68.2%
Patients/practitioner0.01
Specialists3,093
Hospitals80
Users
Employer/payer groups2
Employees & dependents5
Total5Operational date: June 1996.
Service area: Louisiana: 61 parishes.
See CCN Elect consolidated listing under California.
CNA Managed Care-New Orleans
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners2,793
Hospitals25
Service area: Louisiana: New Orleans.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Northern Louisiana
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners404
Hospitals14
Service area: Louisiana: Northern Louisiana.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Southern Louisiana
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners340
Hospitals19
Service area: Louisiana: Southern Louisiana.
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: Louisiana: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare of Louisiana Inc.
4354 S. Sherwood Forest Blvd., Suite D240, Baton Rouge, La. 70816; 504-295-2800; fax: 504-295-2888
Staff/Facilities
Primary practitioners152
Board-certified67%
Patients/practitioner34.5
Specialists304
Hospitals14
Pharmacies866
Users
Employer/payer groups109
Total5,245Operational date: June 1995.
Licensed in: Louisiana.
Model type: IPA.
Service area: Louisiana: Acadia, Allen, Beauregard, Calcasieu, Cameron, Evangeline, Iberia, Jefferson Davis, Lafayette, Lafourche, St. Landry, St. Martin, St. Mary, Terrebonne and Vermilion parishes.
Point-of-service contracts: 50.8% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Dr. Robert Gibbs, medical director; Vicky Smith, provider relations manager; Susan Williams, member services manager; Dee Lance, UM health services manager; Renee Schneider, account manager.
Contact: Vicky Smith.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Louisiana Inc.-Baton Rouge
4354 S. Sherwood Forest Blvd., Suite D240, Baton Rouge, La. 70816; 504-295-2800; fax: 504-295-2888
Staff/Facilities
Primary practitioners206
Board-certified58%
Patients/practitioner86.9
Specialists363
Hospitals14
Pharmacies866
Users
Employer/payer groups248
Total17,904Operational date: March 1986.
Licensed in: Louisiana.
Model type: IPA.
Service area: Louisiana: Pointe Coupee, St. Helena, St. James, Tangipahoa, West Baton Rouge and West Feliciana parishes; Mississippi: Wilkinson County.
Point-of-service contracts: 49% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Dr. Robert Gibbs, medical director; Renee Schneider, account manager; Susan Williams; member services manager; Vicky Smith, provider relations manager; Dee Lance, UM health services manager.
Contact: Vicky Smith.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Louisiana Inc.-New Orleans
3838 N. Causeway Blvd., Suite 2800B, Metairie, La. 70002; 504-832-3004; fax: 504-831-7499
Staff/Facilities
Primary practitioners291
Board-certified70.6%
Patients/practitioner67.7
Specialists881
Hospitals16
Pharmacies1,094
Users
Employer/payer groups260
Total19,176Operational date: July 1989.
Licensed in: Louisiana.
Model type: IPA.
Service area: Louisiana: Jefferson, Orleans, Plaquemines, St. Bernard, St. Charles, St. John the Baptist and St. Tammany parishes; Mississippi: Hancock and Pearl River and Pike counties.
Point-of-service contracts: 60.4% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Dr. Robert Gibbs, medical director; Vicky Smith, provider relations manager; Dee Lance, UM health services manager; Susan Williams; member services manager; Seanie Parker, account manager.
Contact: Vicky Smith.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Louisiana Inc.-Shreveport
6425 Youree Drive, Suite 200, Shreveport, La. 71105-4644; 318-798-4720; fax: 318-798-4737
Staff/Facilities
Primary practitioners111
Board-certified72.7
Patients/practitioner79.1
Specialists193
Hospitals10
Pharmacies118
Users
Employer/payer groups103
Total8,790Operational date: September 1984.
Licensed in: Louisiana.
Model type: IPA.
Service area: Louisiana: Bienville, Bossier, Caddo, Claiborne, De Soto, Hanna, Red River, Sabine, Washington, Webster and West Carroll parishes.
Point-of-service contracts: 20.7% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Dr. Robert Gibbs, medical director; Susan Williams: member services manager; Vicky Smith, provider relations manager; Dee Lance, UM health services manager; Lyndon Darensbourg, planning/analysis-medical economics.
Contact: Vicky Smith, 504-832-7070.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Baton Rouge
4354 S. Sherwood Forest Blvd., Suite D240, Baton Rouge, La. 70816; 504-295-2800; fax: 504-295-2888
Staff/Facilities
Primary practitioners193
Board-certified54.3%
Patients/practitioner29
Specialists421
Hospitals15
Users: Group Health
Employer/payer groups137
Total Users5,588
Operational date: April 1993.
Service area: Louisiana: Ascension, Assumption, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, Saint Helena, Saint James, Tangipahoa, West Baton Rouge and West Feliciana parishes; Mississippi: Amite, Pike and Wilkinson counties.
Officers: Richard Todd, general manager; Dr. Robert Gibbs, medical director; Vicky Smith, provider relations manager; Lyndon Darensbourg, planning/analysis-medical economics.
Contact: Kathleen Gillanders, 860-726-5784.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-New Orleans
3838 N. Causeway Blvd., Suite 2800B, Metairie, La. 70002; 504-832-3004; fax: 504-831-7499
Staff/Facilities
Primary practitioners342
Board-certified71.3%
Patients/practitioner29.7
Specialists1,025
Hospitals18
Users: Group Health
Employer/payer groups229
Total Users10,190
Operational date: July 1991.
Service area: Louisiana: Jefferson, Orleans, Plaquemines, St. Bernard, St. Charles, St. John The Baptist and St. Tammany parishes; Mississippi: Hancock and Pearl Rivers counties.
Officers: Richard Todd, general manager; Dr. Robert Gibbs, medical director; Vicky Smith, provider relations manager; Lyndon Darensbourg, planning/analysis-medical economics.
Contact: Kathleen Gillanders, 860-726-5784.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Shreveport
6425 Youree Drive, Suite 200, Shreveport, La. 71105-4644; 318-798-4720; fax: 318-798-4737
Staff/Facilities
Primary practitioners94
Board-certified78.5%
Patients/practitioner2.5
Specialists156
Hospitals11
Users: Group Health
Employer/payer groups12
Total Users235
Operational date: May 1996.
Service area: Louisiana: Bienville, Bossier, Caddo, Claiborne, De Soto, Red River, Sabine, Washington and Webster parishes.
Officers: Richard Todd, general manager; Dr. Robert Gibbs, medical director; Lyndon Darensbourg, planning/analysis-medical economics.
Contact: Kathleen Gillanders, 860-726-5784.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Southwest Louisiana
4354 S. Sherwood Forest Blvd., Suite D240, Baton Rouge, La. 70816; 504-295-2800; fax: 504-295-2888
Staff/Facilities
Primary practitioners153
Board-certified69.2%
Patients/practitioner6
Specialists322
Hospitals16
Users: Group Health
Employer/payer groups10
Total Users913
Operational date: June 1995.
Service area: Louisiana: Acadia, Allen, Beauregard, Calcasieu, Cameron, Evangeline, Iberia, Jefferson Davis, Lafayette, Lafourche, St. Landry, St. Martin, St. Mary, Terrebonne and Vermilion parishes.
Officers: Richard Todd, general manager; Dr. Robert Gibbs, medical director; Vicky Smith, provider relations manager; Lyndon Darensbourg, planning/analysis-medical economics.
Contact: Kathleen Gillanders, 860-726-5784.
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 practitioners229
Board-certified84%
Specialists1,867*
Hospitals52
Service area: Louisiana.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.