Florida
AHL Select HMO Inc.
1776 American Heritage Life Drive, Jacksonville, Fla. 32224; 904-992-2811; fax: 904-992-2658
Staff/Facilities
Primary practitioners150
Board-certified95%
Specialists500
Hospitals4
Pharmacies58
Primary care locations91Parent: American Heritage Life Insurance Co.
Operational date: April 1997.
Licensed in: Florida.
Model type: IPA.
For profit.
Service area: Florida: Duval and Nassau counties.
Services: General medical, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Officers: T. O'Neal Doullas, chairman/CEO; Chris A. Verlander, vice chairman; James H. Baum, president; K. Pearl Harrison, executive vp; Robert J. Young, senior vp; C. Richard Morehead, treasurer.
Contact: Gerard M. Coster, sales director.
The AHL Select Provider Network
1776 American Heritage Life Drive, Jacksonville, Fla. 32224; 904-992-2656; fax: 904-992-2695
Staff/Facilities
Primary practitioners8,212
Board-certified87%
Specialists13,420
Hospitals139
Users: Group Health
Employer/payer groups48
Single coverage33,927
Family coverage40,126
Employees & dependents158,719
Ownership: American Heritage Life Insurance Co.
Operational date: July 1988.
For profit.
Service area: Florida: statewide, excluding Dixie, Franklin, Gilchrist, Glades, Hendry, Holmes, Jackson, Lafayette, Levy, Liberty, Madison, Taylor and Washington counties.
Contracts with CAPP CARE nationwide; Carillion Health Plan in Virginia; Gulf Health Plan in Alabama; Healthchoice in Alabama; HealthStar in North Carolina; MedCost in North Carolina, South Carolina; North Texas Healthcare Network in Texas; OneSource Health Network in North Carolina, South Carolina; Preferred Health Plan in Tennessee; SouthCare in Georgia; Southeast Medical Alliance in Arkansas, Louisiana, Mississippi; Virginia Health Network in Virginia.
Services: General medical, mental health, chiropractic, OB/GYN, podiatry. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers.
UR: Standard procedures, including prenatal review. UR provided by the PPO.
Officers: C. Richard Morehead, president; James H. Baum, senior vp-group department; K. Pearl Harrison, vp-claims/health care relations; Robert J. Young, vp-group marketing; Dr. Richard Glock, medical director.
Contact: Lisa S. Turley.
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities
Primary practitioners3,574
Specialists7,096
Hospitals109
Users
Employees & dependents158,689
Operational date: September 1991.
Service area: Florida: 56 counties.
See Admar Med Network consolidated listing under California.
All Florida PPO Inc.
351 S. Cypress Road, Suite 303, Pompano Beach, Fla. 33060-7166; 800-831-9710 or 954-946-5183; fax: 954-946-0978
Staff/Facilities
Primary practitioners2,892
Board-certified85.3%
Specialists7,223
Hospitals118
Pharmacies2,452
Users: Group Health
Employer/payer groups10
Total Users161,000
Operational date: July 1993.
For profit.
Service area: Florida: statewide.
Services: General medical, vision, prescription drug, mental health, workers compensation. 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. UR provided by outside contractors.
Contact: Reg Watkins, president.
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 practitioners1,800
Board-certified100%
Hospitals420
Ownership: Managed Care Networks Inc.
Operational date: January 1994.
For profit.
Service area: Alabama, Arizona, Arkansas, California, Colorado, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, Wisconsin.
Services: Workers compensation; medical diagnostic imaging, including MRI, CT, bone densitometry, general X-ray. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by client-specific arrangements; is compensated by employers/payers, insurers, TPAs.
UR: Precertification, retrospective review, second surgical opinion, outpatient service predetermination, case management. UR provided by the PPO.
Officers: Michael Cabrera, president; Donna Cabrera, director-operations; Cecelia O'Donnell, director-client services; Paul Marineau, director-managed care.
**Figures are consolidated, including all PPO plans in this organization.
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 practitioners450
Hospitals127
Service area: Florida: statewide.
See AnciCare PPO consolidated listing under Florida.
AvMed Health Plan
9500 S. Dadeland Blvd., Miami, Fla. 33156; 305-671-4701; fax: 305-671-4783
Staff/Facilities
Primary practitioners1,906
Board-certified76.2%
Patients/practitioner173
Specialists4,981
Hospitals129
Pharmacies1,320
Primary care locations2,221
Users
Employer/payer groups4,891
Single coverage63,644
Family coverage62,924
Employees & dependents260,729
Medicare69,273
Total347,542
Revenues
First-half 1997$389,720,141*
1996$322,967,727Parent: AvMed Inc.
Operational date: January 1973.
Federally qualified.
Licensed in: Florida.
NCQA fully accredited.
Model type: IPA.
Not for profit.
Service area: Florida: 31 counties.
Services: General medical, vision, prescription drug, mental health, substance abuse. May be customized to meet employer specifications.
Rating options: Community rating: $156.77 single, $470.31 family; community rating by class; adjusted community rating.
Point-of-service contracts: 1% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Edward C. Peddie, CEO; Dr. James Moffat, group vp-medical operations; Don Hairston, group vp/CFO; Ed Hannum, group vp-service; Robert Hudson, executive vp/general manager.
**Includes Medicare revenue.
Bay Care Health Network
17757 U.S. Highway 19 N., Clearwater, Fla. 34624; 813-535-3335;
fax: 813-532-6188
Staff/Facilities
Primary practitioners831
Specialists1,367
Hospitals18
Users: Group Health
Single/family coverage53,640
Employees & dependents*134,100
Users: Workers Compensation
Single coverage439,649
Total Users573,649
Operational date: June 1991.
For profit.
Service area: Florida: Hernando, Hillsborough, Manatee, Pasco, Pinellas and Sarasota counties.
Services: General medical, vision, prescription drug, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee.
UR: Standard procedures, excluding hospital bill audits. UR provided by the PPO
Officers: John K. Vretas, president/CEO; Steve Halverson, vp-sales; Barbara Brzezinski, director-network services; Sheree Harman, director-workers compensation; Dr. Mark Michelman, medical director.
Contact: Steve Halverson.
**Estimate.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners6,910
Specialists26,230
Hospitals152
Users: Group Health
Single coverage76,855
Family coverage337,866
Employees & dependents853,946
Users: Workers Compensation
Single coverage54,270
Total Users908,216
Operational date: 1987.
Service area: Florida: 67 counties.
See Beech Street Corp. consolidated listing under California.
Bradman/Unipsych Cos.
7777 Davie Road Extension, Suite 100, Hollywood, Fla. 33024; 954-704-8686; fax: 954-704-8677
Specialty: mental health
Staff/Facilities
Primary practitioners700
Board-certified50%
Hospitals70
Users: Group Health
Employer/payer groups50
Employees & dependents600,000
Users: Workers Compensation
Employer/payer groups2
Operational date: 1986.
For profit.
Service area: Florida, Georgia, North Carolina, South Carolina.
Services: Mental health. Services available unbundled.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers, insurers; charges flat fee per employee.
UR: Standard procedures. UR provided by the PPO.
Officers: Dr. Leo Bradman, chairman/CEO; Denise Scott, vp-administration; Dr. Ernest Cohen, psychiatric director.
Contact: Dr. Leo Bradman.