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1997 DIRECTORY OF MANAGED CARE PROVIDERS

Reprints

New Mexico
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities*
Primary practitioners389
Specialists1,236
Hospitals21
Users
Employees & dependents54,667
Operational date: November 1988.
Service area: New Mexico: 29 counties.
**Includes leased providers/facilities.
See Admar Med Network consolidated listing under California.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners302
Specialists957
Hospitals11
Users: Group Health
Single coverage5,391
Family coverage23,699
Employees & dependents59,898
Users: Workers Compensation
Single coverage2,128
Total Users62,026
Operational date: 1987.
Service area: New Mexico: 23 counties.
See Beech Street Corp. consolidated listing under California.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners420
Board-certified29.8%
Patients/practitioner30.6
Specialists815
Hospitals11
Users: Group Health
Employer/payer groups108
Employees & dependents10,483
Total Users10,483
Service area: New Mexico: Bernalillo, Cibola, Dona Ana, Lea, Los Alamos, Luna, McKinley, Rio Arriba, Roosevelt, San Juan, San Miguel, Sandoval, Santa Fe, Socorro, Torrance and Valencia counties.
Services: General medical, mental health, ancillary services.
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 practitioners420
Board-certified29.8%
Patients/practitioner6.2
Specialists813
Hospitals11
Users
Employer/payer groups2
Employees & dependents2,605
Total2,605
Revenues
First-half 1997$54,656
1996$68,310Operational date: January 1996.
Service area: New Mexico: Bernalillo, Cibola, Dona Ana, Lea, Los Alamos, Luna, McKinley, Rio Arriba, Roosevelt, San Juan, San Miguel, Sandoval, Santa Fe, Socorro, Torrance and Valencia counties.
See CCN Elect consolidated listing under California.
CNA Managed Care-New Mexico
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners648
Hospitals13
Service area: New Mexico.
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 practitioners*77
Board-certified72.6%
Patients/practitioner28.8
Hospitals10
Service area: New Mexico: Bernalillo, Chaves, Cibola, Curry, Dona Ana, Eddy, Lea, Lincoln, Otero, Quay, Rio Arriba, Roosevelt, Sandoval, Santa Fe, Socorro and Valencia 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 practitioners1
Service area: New Mexico: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA Managed Care Network of New Mexico
5301 Central N.E., Suite 1500, Albuquerque, N.M. 87108; 505-262-3850; fax: 505-262-3867
Staff/Facilities
Primary practitioners555
Board-certified81.9%
Patients/practitioner64.1
Specialists1,072
Hospitals6
Pharmacies207
Users
Employer/payer groups129
Total35,621Operational date: December 1994.
Licensed in: New Mexico.
Model type: IPA/Staff.
Service area: New Mexico: 22 counties.
Point-of-service contracts: 54% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Ron Howrigon, Healthplan president; Dr. Michael Coyle, medical director; Gayle Adams, vp-sales; Marylyn Kirk, UM health services manager; Lynn Allen, provider relations manager.
Contact: Maggie Anaya.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Albuquerque
5301 Central N.E., Suite 400, Albuquerque, N.M. 87108; 505-262-3850; fax: 505-262-3867
Staff/Facilities
Primary practitioners551
Board-certified82%
Patients/practitioner23.6
Specialists1,259
Hospitals28
Users: Group Health
Employer/payer groups214
Total Users13,130
Operational date: June 1988.
Service area: New Mexico: 34 counties.
Officers: Ron Howigan, executive director/regional contracting officer; Diana McEnnerney, director/manager-operations; Dr. John Lucas, general manager; Dr. Michael Coyle, medical director; Gayle Adams, 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 practitioners505
Board-certified85%
Specialists1,520*
Hospitals31
Service area: New Mexico.
**Includes ancillary providers.
der California.
Guardian Resources Inc.
2739 U.S. Highway 19 N., Suite 350, Holiday, Fla. 34691; 813-938-2222; 813-938-2880
Staff/Facilities
Primary practitioners419
Board-certified62%
Specialists538
Hospitals35
Users: Group Health
Employer/payer groups29
Single coverage3,000
Family coverage2,400
Employees & dependents8,200
Total Users8,200
Service area: New Mexico: statewide.
See Guardian Resources consolidated listing under Florida.
Health Management Network
1600 W. Broadway Road, Suite 385, Tempe, Ariz. 85282; 602-921-8944;
fax: 602-894-5230
Staff/Facilities
Primary practitioners700
Board-certified77%
Specialists1,965
Hospitals31
Users: Group Health
Employer/payer groups157
Single coverage12,400
Family coverage10,500
Employees & dependents51,000
Users: Workers Compensation
Employer/payer groups1
Single coverage500
Total Users51,500
Service area: New Mexico.
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*461
Specialists701
Hospitals**21
Service area: New Mexico: 28 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Lovelace Health Systems Inc.
5301 Central N.E., Suite 1500; Albuquerque, N.M. 87125-7107; 505-262-7363; fax: 505-262-7545
Staff/Facilities
Primary practitioners622
Board-certified82.2%
Patients/practitioner224.6
Specialists972
Hospitals35
Pharmacies224
Users
Employer/payer groups777
Total139,704Operational date: January 1973.
Federally qualified.
Licensed in: New Mexico.
NCQA fully accredited.
Model type: IPA/Staff.
Service area: New Mexico: 34 counties.
Point-of-service contracts: 16.9% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Ron Howrigon, executive director; Martin Hickey, director/manager-operations; Dr. Michael Coyle, medical director; Brynne Badeaux, CFO; Mary McKenzie; Medicare sales manager.
Contact: Maggie Anaya.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners88
Board-certified82.4%
Specialists313
Hospitals21
Users: Group Health
Employer/payer groups2
Employees & dependents146,166
Service area: New Mexico: statewide, excluding Catron, De Baca, Guadalupe, Harding, Mora and Torrance counties.
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 practitioners4
Service area: New Mexico: cities of Albuquerque and Las Cruces.
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 practitioners508
Specialists1,125
Hospitals22
Users: Group Health
Employer/payer groups13
Employees & dependents39,747
Total Users39,747
Service area: New Mexico.
See National Preferred Provider Network Inc. consolidated listing under New York.
Private Healthcare Systems Inc.
2525 E. Camelback Road, Suite 755, Phoenix, Ariz. 85016; 602-553-7444;
fax: 602-553-7447
Staff/Facilities
Primary practitioners192
Board-certified85%
Specialists337
Hospitals14
Pharmacies232
Users
Employees & dependents2,150
Total2,150Service Area: New Mexico: cities of Albuquerque, Las Cruces and Santa Fe.
See Private Healthcare Systems POS consolidated listing under Massachusetts.
Private Healthcare Systems
2525 E. Camelback, Suite 755, Phoenix, Ariz. 85016; 602-553-7444; fax: 602-553-7447
Staff/Facilities
Primary practitioners306
Board-certified85%
Specialists337
Hospitals14
Pharmacies232
Users: Group Health
Employees & dependents18,096
Total Users18,096
Operational date: May 1987.
Service area: New Mexico: cities of Albuquerque, Las Cruces and Santa Fe.
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 practitioners159
Specialists189
Hospitals12
Users: Group Health
Employees & dependents8,050
Total Users8,050
Service area: New Mexico: statewide.
See ProAmerica Managed Care consolidated listing under Texas.
QualMed Health & Life Insurance Co.
225 N. Main St., Pueblo, Colo. 81003; 800-847-1528; fax: 719-585-8291
Staff/Facilities
Primary practitioners320
Board-certified92%
Patients/practitioner89
Specialists698
Hospitals22
Pharmacies62
Users
Employer/payer groups1
Single coverage44
Family coverage1
Employees & dependents46
Total Users46
Ownership: Foundation Health Systems Inc.
Operational date: January 1993.
Service area: New Mexico: Bernalillo, Los Alamos, Mora, Rio Arriba, San Miguel, Sandoval, Santa Fe, Taos, Torrence and Valencia counties.
Services: General medical, prescription drug, mental health. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures. UR provided by the PPO.
Officers: Darnell Dent, president/CEO; Brian Crary, treasurer; Kevin Staab, secretary/director-finance; Kathleen McCafferty, director-medical management; Michael Tullos, director, legal affairs.
Contact: Ginny Salomon.
See Foundation Health Systems consolidated listing under California.
QualMed Plans for Health Inc.
6100 Uptown Blvd. N.E., Suite 400, Albuquerque, N.M. 87110; 505-889-8800; fax: 505-889-8819
Staff/Facilities
Primary practitioners320
Board-certified92%
Patients/practitioner89
Specialists698
Hospitals22
Pharmacies62
Primary care locations52
Users
Employer/payer groups1,145
Single coverage6,048
Family coverage6,350
Medicare2,218
Total30,105Parent: Foundation Health Systems Inc.
Operational date: April 1994.
Federally qualified.
Licensed in: New Mexico.
Model type: IPA.
Service area: New Mexico: Bernalillo, Los Alamos, Mora, Rio Arriba, San Miguel, Sandoval, Santa Fe, Taos, Torrence and Valencia.
Services: General medical, vision, prescription drug, organ transplant, chiropractic. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Len Kalm, president; Dr. Steven Komadina, vice chairman, Dr. Krisna Chonsiriwatana, secretary; Dr. Richard Burton, assistant secretary; Duane Scholer, regional controller.
Contact: Marc Neely, regional sales director, 303-584-4825.
See Foundation Health Systems consolidated listing under California.
USA H&W Network
7301 N. 16th St., Suite 201, Phoenix, Ariz. 85020; 602-371-3860; fax: 602-371-3889
Staff/Facilities
Primary practitioners362
Specialists611
Hospitals9
Users: Group Health
Single/family coverage15,124
Employees & dependents34,785
Total Users34,785
Operational date: April 1986.
Service Area: New Mexico: Bernalillo, Cibola, Dona Ana, Eddy, Lea, Lincoln, Los Alamos, Luna, McKinley, Rio Arriba, Roosevelt, San Juan, San Miguel, Sandoval, Santa Fe, Sierra, Socorro and Valencia 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 practitioners245
Specialists563
Hospitals6
Users: Workers Compensation
Single coverage9,857
Total Users9,857
Operational date: April 1986.
Service area: New Mexico: Bernalillo, Cibola, Dona Ana, Eddy, Lea, Lincoln, Los Alamos, Luna, McKinley, Rio Arriba, Roosevelt, San Juan, San Miguel, Sandoval, Santa Fe, Sierra, Socorro and Valencia counties.
See USA Workers' Injury Network consolidated listing under Texas.
United HealthCare Insurance Co.
6251 Greenwood Plaza Blvd., Suite 200, Englewood, Colo. 80111; 303-694-9336; fax: 303-267-3599
Staff/Facilities
Primary practitioners 150
Board-certified59%
Specialists395
Hospitals4
Pharmacies50
Users:
Employer/payer groups190
Total Users11,356
Operational date: January 1994.
Service area: New Mexico: Bernalillo, Eddy, Sandoval, Santa Fe and Valencia counties.
Services: General medical, prescription drug, mental health/substance abuse.
Contact: Sharon Swan, vp-sales.
See United HealthCare Corp. PPO consolidated listing under Minnesota.