West Virginia
American Service Life PPO
887 National Road, Wheeling, W.Va. 26003; 304-234-5100; fax: 304-234-5119
Staff/Facilities
Primary practitioners300
Specialists456
Hospitals13
Users
Employees & dependents21,114
Total Users21,114
Operational date: June 1995.
Service area: West Virginia: Barbour, Brooke, Doddridge, Hancock, Harrison, Lewis, Marion, Marshall, Monongalia, Ohio, Preston, Taylor, Upshur and Wetzel counties.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers; charges premiums.
UR: Standard procedures. UR provided by the PPO.
See HealthAssurance PPO consolidated listing under Pennsylvania.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners11
Specialists21
Hospitals5
Users: Group Health
Single coverage2,671
Family coverage10,452
Employees & dependents26,711
Total Users26,711Operational date: 1993.
Service area: West Virginia: 26 counties.
See Beech Street Corp. consolidated listing under California.
CNA Managed Care-West Virginia
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners268
Hospitals12
Service area: West Virginia.
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 practitioners1
Service area: West Virginia: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA Managed Care Network of West Virginia/Southeast Ohio
5005 Rockside Road, Suite 700, Cleveland, Ohio 44131; 216-642-2920; fax: 216-642-2990
Staff/Facilities
Primary practitioners289
Board-certified64%
Patients/practitioner72.8
Specialists477
Hospitals21
Pharmacies175
Users
Employer/payer groups216
Total21,052Operational date: January 1994.
Licensed in: Ohio, West Virginia.
Model type: IPA.
Service area: Ohio: Athens, Belmont, Meigs, Noble and Washington counties; West Virginia: Boone, Fayette, Harrison, Jackson, Kanawha, Marion, Marshall, Monongalia, Ohio, Pleasants, Preston, Putnam, Raleigh, Ritchie, Roane, Tyler, Wetzel, Wirt and Wood counties.
Point-of-service contracts: 70% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Ron Dziedzicki, director/manager-operations/regional contracting officer; Dr. Jannifer Harper, medical director; Dr. David Cogan, associate medical director; Marilyn Spitaleri, quality assurance manager; Kathy Eck, UM heath services manager.
Contact: Kathy Oplingel.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Parkersburg/
Marietta
5005 Rockside Road, Suite 700, Cleveland, Ohio 44131; 216-642-2920; fax: 216-642-2990
Staff/Facilities
Primary practitioners294
Board-certified64.3%
Patients/practitioner15.7
Specialists514
Hospitals22
Users: Group Health
Employer/payer groups94
Total Users4,640
Operational date: January 1994.
Service area: Ohio: Athens, Belmont, Meigs, Noble and Washington counties; West Virginia: Boone, Fayette, Harrison, Jackson, Kanawha, Marion, Marshall, Monongalia, Ohio, Pleasants, Preston, Putnam, Raleigh, Ritchie, Roane, Tyler, Wetzel, Wirt and Wood counties.
Officers: Ron Dziedzicki, regional contracting officer/executive director; Dr. Jannifer Harper, medical director; Cheryl Colles, 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 practitioners3
Board-certified83%
Specialists157*
Hospitals11
Service area: West Virginia.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
HealthAssurance
HMO/POS
887 National Road, Wheeling, W.Va. 26003; 304-234-5100; fax: 304-234-5119
Staff/Facilities
Primary practitioners300
Specialists456
Hospitals13
Pharmacies319
Primary care locations278
Users
Employer/payer groups5
Single coverage988
Family coverage3,823
Total19,248Operational date: July 1995.
Service area: West Virginia: Barbour, Brooke, Doddridge, Hancock, Harrison, Lewis, Marion, Marshall, Monongalia, Ohio, Preston, Taylor, Upshur and Wetzel counties.
Services: General medical, prescription drug, mental health, chiropractic.
See HealthAmerica/HealthAssurance consolidated listing under Pennsylvania.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*114
Specialists175
Hospitals**18
Service area: West Virginia: 41 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners*NA
Specialists*NA
Hospitals16
Users: Group Health
Employer/payer groups6
Employees & dependents120,735
Service area: West Virginia: 39 counties.
**Practitioner network not yet established.
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 practitioners11
Service area: West Virginia: cities of Beckley, Bluefield, Bridgeport, Clarksburg, Farmington, Huntington, Keyser, Martinsburg, Parkersburg, Princeton and South Charleston.
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 practitioners102
Specialists109
Hospitals14
Users: Group Health
Employer/payer groups15
Employees & dependents25,502
Total Users25,502
Service area: West Virginia.
See National Preferred Provider Network Inc. consolidated listing under New York.
Parker Benefits Inc. dba SuperBlue HMO
700 Market Square, Parkersburg, W.Va. 26101; 304-347-7768; fax: 304-347-7743
Staff/Facilities
Primary practitioners366
Specialists918
Hospitals18
Users
Employer/payer groups1
Single coverage250
Family coverage355
Employees & dependents1,310
Total1,310
Revenues
First-half 1997$1,391,329Parent: Mountain State Blue Cross & Blue Shield.
Operational date: January 1997.
Licensed in: West Virginia.
Model type: Network.
For profit.
Service area: West Virginia: Greenbrier, Jackson, Kanawha, Ohio, Marion, Marshall, Mercer, Monongalia, Pleasants, Putnam, Raleigh, Ritchie, Wirt and Wood counties.
SuperBlue HMO contracts with Blue Cross & Blue Shield Assn. nationwide.
Services: General medical, dental, vision, prescription drug, mental health, preventive care, wellness programs. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Officers: Greg Smith, president/CEO; Mark Sengewalt, treasurer/CFO; J. Fred Earley II, secretary/general counsel; Colin Drozdowski, executive director.
Contact: Edward Hamilton, principal/director-new market development, 304-347-7779.
Private Healthcare Systems Inc.
20 Burton Hills Blvd., Nashville, Tenn. 37215; 615-665-1888; fax: 615-665-0035
Staff/Facilities
Primary practitioners1
Board-certified81%
Specialists116
Hospitals12
Pharmacies489
Users
Employees & dependents2
Total2Service Area: West Virginia: cities of Parkersburg, Pendleton, Pocahontas, Mercer and Wheeling.
See Private Healthcare Systems POS consolidated listing under Massachusetts.
Private Healthcare Systems
20 Burton Hills Blvd., Nashville, Tenn. 37215; 615-665-1888; fax: 615-665-0035
Staff/Facilities
Primary practitioners127
Board-certified81%
Specialists116
Hospitals12
Pharmacies489
Users: Group Health
Employees & dependents23,138
Total Users23,138
Operational date: May 1987.
Service area: West Virginia: cities of Mercer, Parkersburg, Pendleton, Pocahontas and Wheeling.
See Private Healthcare Systems PPO consolidated listing under Massachusetts.
SelectNet Plus Inc.
1 Hillcrest Drive E., Charleston, W.Va. 25326; 304-347-0730; fax: 304-347-0746
Staff/Facilities
Primary practitioners825
Board-certified70%
Patients/practitioner75
Specialists1,450
Hospitals38
Users: Group Health
Employer/payer groups370
Single coverage9,100
Family coverage15,770
Employees & dependents60,000
Total Users60,000
Ownership: Acordia National.
Operational date: July 1985.
For profit.
Service area: Kentucky: Boyd, Floyd, Greenup, Lawrence, Martin and Pike counties; Maryland: Allegany, Frederick, Garret and Washington counties; Ohio: Athens, Belmont, Columbiana, Gallia, Jefferson, Lawrence, Meigs, Monroe and Washington counties; Pennsylvania: Beaver, Fayette, Greene, Somerset and Washington counties; Virginia: Alleghany, Bath, Buchanan, Clarke, Craig, Frederick, Giles, Highland, Loudoun, Rockingham, Shenandoah and Tazewell counties; West Virginia: statewide.
Services: General medical, vision, mental health. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee, by percent of savings.
UR: Standard procedures excluding discharge planning. UR provided by the PPO.
Officers: Andrew Paterno, president; J. Hart, vp; Rick Legg, vp; Judy Thomas, secretary; Valorie Raines, director-operations.
SuperBlue Plus
900 Pennsylvania Ave., P.O. Box 1353, Charleston, W.Va. 25325; 304-347-7768; fax: 304-347-7743
Staff/Facilities
Hospitals68
Pharmacies*40,000
Users: Group Health
Employer/payer groups1,056
Single coverage17,686
Family coverage30,811
Employees & dependents120,854
Total Users120,854
Ownership: Mountain State Blue Cross & Blue Shield.
Operational date: April 1994.
Not for profit.
Service area: Kentucky: Boyd, Lawrence, Martin and Pike counties; Maryland: Allegany and Washington counties; Ohio: Athens, Belmont, Carroll, Columbiana, Gallia, Harrison, Jefferson, Lawrence, Meigs, Monroe and Washington counties; Pennsylvania: Allegheny, Greene and Washington counties; Virginia: Bland, Buchanan, Frederick, Rockingham and Tazewell counties; West Virginia: 55 counties.
Contracts with BlueCard PPO nationwide.
Services: General medical, dental, vision, prescription drug, mental health. 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; charges flat fee per employee.
UR: Standard procedures excluding outpatient service predetermination. UR provided by the PPO.
Officers: Greg Smith, president/CEO; Mark Sengewalt, treasurer/CFO; J. Fred Earley II, secretary/general counsel.
Contact: Edward Hamilton, 304-347-7779.
**Nationwide total.
SuperBlue Select
Mountain State Blue Cross & Blue Shield, 900 Pennsylvania Ave., P.O. Box 1353, Charleston, W.Va. 25325; 304-347-7768; 304-347-7743
Staff/Facilities
Primary practitioners1,064
Specialists3,386
Hospitals67
Users
Employer/payer groups131
Single coverage5,122
Family coverage11,763
Employees & dependents40,721
Total40,721Parent: Mountain State Blue Cross & Blue Shield.
Operational date: April 1994.
Licensed in: West Virginia.
Model type: IPA.
Not for profit.
Service area: Kentucky: Boyd, Lawrence, Martin and Pike counties; Maryland: Alleghany and Washington counties; Ohio: Athens, Belmont, Carrell, Columbiana, Gallia, Harrison, Jefferson, Lawrence, Meigs, Monroe and Washington counties; Pennsylvania: Allegheny, Greene and Washington counties; Virginia: Bland, Buchanan, Frederick, Rockingham and Tazewell counties; West Virginia: 55 counties. Member of Blue Cross & Blue Shield Assn.
Contracts with HMO Blue USA nationwide (pending) and Blue Cross & Blue Shield Assn.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Officers: Greg Smith, president/CEO; Mark Sengewalt, treasurer/CFO; J. Fred Earley II, secretary/general counsel.
Contact: Edward Hamilton 304-347-7779.
USA H&W Network
7301 N. 16th St., Suite 201, Phoenix, Ariz. 85020; 602-371-3860; fax: 602-371-3889
Staff/Facilities
Primary practitioners31
Specialists43
Hospitals4
Users: Group Health
Single/family coverage11,834
Employees & dependents27,218
Total Users27,218
Operational date: April 1989.
Service Area: West Virginia: Berkely, Boone, Cabell, Fayette, Jefferson, Kanawha, Marion, Mason, Mercer, Monongalia, Nicholas, Ohio, Putnam, Raleigh, Wood and Wyoming 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 practitioners18
Specialists44
Hospitals4
Users: Workers Compensation
Single coverage74,628
Total Users74,628
Operational date: April 1989.
Service area: West Virginia: Berkely, Boone, Cabell, Fayette, Jefferson, Kanawha, Marion, Mason, Mercer, Monongalia, Nicholas, Ohio, Putnam, Raleigh, Wood and Wyoming counties.
See USA Workers' Injury Network consolidated listing under Texas.
United HealthCare Insurance Co.
8330 Boone Blvd., Suite 300, Vienna, Va. 22182; 703-918-4000; fax: 703-918-4059
Staff/Facilities
Primary practitioners70
Board-certified42%
Specialists270
Hospitals1
Users:
Employer/payer groups147
Total Users10,474
Operational date: January 1984.
Service area: West Virginia: Berkeley and Morgan counties.
Services: General medical, prescription drug, mental health/substance abuse.
Contact: Katie Kelly, vp-sales/marketing.
See United HealthCare Corp. PPO consolidated listing under Minnesota.