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1997 DIRECTORY OF MANAGED CARE PROVIDERS

Reprints

Virginia
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities*
Primary practitioners267
Specialists1,039
Hospitals14
Users
Employees & dependents18,699
Operational date: March 1992.
Service area: Virginia: Arlington, Botetourt, Fairfax, Fauquier, Henrico, Loudoun, Prince William and Strafford counties and the cities of Alexandria, Fairfax, Falls Church, Fredericksburg, Manassas, Newport News, Roanoke, Virginia Beach and Winchester.
See Admar Med Network consolidated listing under California.
AMERICAID Community Care*
4425 Corporation Lane, Suite 100, Virginia Beach, Va. 23462; 757-490-6900; fax: 757-490-7152
Staff/Facilities
Primary practitioners2,307
Board-certified31%
Specialists6,618
Hospitals124
Pharmacies3,409
Primary care locations4,614
Users
Medicaid38,261
Total38,261
Revenues
First-half 1997$31,315,405
1996$23,417,131Parent: AMERICAID Inc.
Operational date: December 1994.
Licensed in: Georgia, Illinois, New Jersey, Texas.
Model type: Network.
For profit.
Service area: Georgia, Illinois, New Jersey, Texas.
Services: General medical, vision, prescription drug, mental health.
Rating options: Community rating by class (New Jersey only). Others N/A.
Offers self-insured products.
Officers: Jeffrey L. McWaters, president/CEO; Dr. Lorenzo Childress Jr., chief medical officer; Theodore M. Wille, COO; Kathleen K. Toth, vp-finance.
Contact: Julia Fay George.
**Figures are consolidated, including all HMO 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 practitioners3
Hospitals2
Service area: Virginia: Fairfax and Price William counties.
See AnciCare PPO consolidated listing under Florida.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners306
Board-certified85%
Patients/practitioner13.3
Specialists997
Hospitals39
Users: Group Health
Employer/payer groups50
Employees & dependents698
Users: Workers Compensation
Employer/payer groups13
Total Users*698
Service area: Virginia: 61 counties.
Services: General medical, mental health, workers compensation, ancillary services.
**Does not include workers compensation users.
See CCN consolidated listing under California.
CNA Managed Care-Richmond
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners4,571
Hospitals22
Service area: Virginia: Richmond.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Roanoke
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners384
Hospitals8
Service area: Virginia: Roanoke.
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*691
Board-certified64.7%
Patients/practitioner30
Hospitals17
Service area: Virginia: 29 counties; the cities of Alexandria, Chesapeake, Fairfax, Falls Church, Fredericksburg, Falls Church, Hampton, Harrisonburg, James, Newport News, Norfolk, Portsmouth, Richmond, Roanoke, Salem, Staunton, Suffolk, Virginia Beach and Williamsburg.
**Includes specialists.
See CAPP CARE Inc. consolidated listing under California.
Carilion Health Plans Inc.
110 Campbell Ave., Suite 107, Roanoke, Va. 24011; 800-856-5206; fax: 540-857-5205
Staff/Facilities
Primary practitioners260
Board-certified100%
Patients/practitioner200
Specialists495
Hospitals15
Pharmacies130
Users: Group Health
Employer/payer groups85
Employees & dependents70,000
Users: Workers Compensation
Employer/payer groups1
Single coverage15,000
Total Users85,000
Ownership: Carilion Health System.
Operational date: January 1993.
For profit.
Service area: Virginia: 22 counties.
Services: General medical, mental health, workers compensation. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by discount off customary rates; is compensated by employers/payers, insurers, TPAs, third party networks; charges flat fee per employee.
UR: Standard procedures excluding retrospective review, hospital bill audits and outpatient service predetermination. UR provided by the PPO.
Officers: Thomas O. Maxfield, executive director; Dr. Rome Walker, medical director; Carolyn Chrisman, director-sales/contracting; Janet Niles, director-utilization management; Diane Rinehard, director-provider relations; Susan Carty, director-administration/member services.
Contact: Bryan Hyler, senior account representative.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners13
Service area: Virginia: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare of Virginia Inc.-Hampton Roads
200 Golden Oak Court, Reflections II, Suite 450, Virginia Beach, Va. 23452; 800-468-2204; fax: 804-463-2134
Staff/Facilities
Primary practitioners369
Board-certified77%
Patients/practitioner157.3
Specialists1,262
Hospitals24
Pharmacies611
Users
Employer/payer groups385
Total58,070Operational date: May 1984.
Licensed in: Virginia.
NCQA fully accredited.
Model type: IPA.
Service area: Virginia: Gloucester, Isle of Wight, James City, King and Queen, Mathews, Middlesex and York counties and the cities of Chesapeake, Hampton, Newport News, Norfolk, Poquoson, Portsmouth, Suffolk, Virginia Beach and Williamsburg.
Point-of-service contracts: 69.7% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Greg Bowman, CFO/general manager; Dr. Douglas Hadley, medical director; Linda Butz, vp-sales; Debbi Taylor, quality assurance manager; LaTricia Norris, UM health services manager.
Contact: Marvalee Brown.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA HealthCare of Virginia Inc.-Richmond
4050 Innslake Drive, Glen Allen, Va. 23060; 804-273-1100; fax: 804-273-1219
Staff/Facilities
Primary practitioners404
Board-certified77%
Patients/practitioner221.4
Specialists1,472
Hospitals14
Pharmacies611
Users
Employer/payer groups454
Medicare1,143
Total90,600Operational date: May 1984.
Licensed in: Virginia.
NCQA fully accredited.
Model type: IPA.
Service area: Virginia: Amelia, Caroline, Charles City, Chesterfield, Cumberland, Dinwiddie, Goochland, Greensville, Hanover, Henrico, King William, Louisa, New Kent, Nottoway, Powhatan, Prince George, Surry and Sussex counties and the cities of Colonial Heights, Hopewell, Petersburg and Richmond.
Point-of-service contracts: 43% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Greg Bowman, CFO/general manager; Dr. Douglas Hadley, medical director; Betty Balluzzo, vp-sales; Debbi Taylor, quality assurance manager; LaTricia Norris, UM health services manager.
Contact: Marvalee Brown.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA Managed Care Network Inc. of Western Virginia
4050 Innslake Drive, Glen Allen, Va. 23060; 804-273-1100; fax: 804-273-1219
Staff/Facilities
Primary practitioners363
Board-certified80.4%
Patients/practitioner67.5
Specialists949
Hospitals9
Pharmacies611
Users
Employer/payer groups108
Total24,528Operational date: January 1996.
Licensed in: Virginia.
Model type: IPA.
Service area: Virginia: 23 counties; the cities of Bedford, Charlottesville, Harrisonburg, Lynchburg, Martinsville, Roanoke, Salem, Staunton and Waynesboro.
Point-of-service contracts: 73% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Linda M. Butz, vp-sales; Greg Bowman, general manager/executive director;
Dr. Douglas Hadley, medical director; Robert Hutchinson, director-client services/member services manager; Jean McGraw, director-information systems.
Contact: Marvalee Brown, 804-560-3946.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Hampton Roads
200 Golden Oak Court, Reflections II, Suite 450, Virginia Beach, Va. 23452; 800-468-2204; fax: 804-463-2134
Staff/Facilities
Primary practitioners466
Board-certified81.2%
Patients/practitioner31.7
Specialists1,327
Hospitals13
Users: Group Health
Employer/payer groups224
Total Users14,793
Operational date: February 1990.
Service area: Virginia: Gloucester, Isle of Wight, King and Queen, Mathews, Middlesex, Virginia Beach and York counties and the cities of Chesapeake, Hampton, James, Newport News, Norfolk, Poquoson, Portsmouth, Suffolk, Virginia Beach and Williamsburg.
Officers: Greg Bowman, executive director; Dr. Douglas Hadley, medical director, Robert Hutchinson, director-client services; Linda M. Butz, vp-sales; Jean McGraw, director-information systems.
Contact: Kathleen Gillanders, 860-726-5784.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Richmond
4050 Innslake Drive, Glen Allen, Va. 23060; 804-273-1100; fax: 804-273-1219
Staff/Facilities
Primary practitioners530
Board-certified75.7%
Patients/practitioner38.7
Specialists1,482
Hospitals18
Users: Group Health
Employer/payer groups306
Total Users20,534
Operational date: February 1990.
Service area: Virginia: 22 counties.
Officers: Betty Balluzzo, vp-sales; Greg Bowman, executive director/general manager; Dr. Douglas Hadley, medical director; Jean McGraw, director-information systems; Rachel Schneider, provider relations manager.
Contact: Kathleen Gillanders, 860-726-5784.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-Western Virginia
4050 Innslake Drive, Glen Allen, Va. 23060; 804-273-1100; fax: 804-273-1219
Staff/Facilities
Primary practitioners376
Board-certified81.4%
Patients/practitioner5.4
Specialists785
Hospitals9
Users: Group Health
Employer/payer groups60
Total Users2,055
Operational date: January 1996.
Service area: Virginia: 23 counties and the cities of Bedford, Charlottesville, Danville, Harrisonburg, Lynchburg, Martinsville, Roanoke, Salem, Staunton and Waynesboro.
Officers: Linda M. Butz, vp-sales; Greg Bowman, executive director/general manager; Dr. Douglas Hadley, medical director; Robert Hutchinson, director-client services; Jean McGraw, director-information systems.
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 practitioners1,080
Board-certified97%
Specialists4,097*
Hospitals35
Service area: Virginia.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
FOCUS Healthcare Management Inc.
7101 Executive Center Drive, Suite 375, Brentwood, Tenn. 37207; 800-873-0055 or 615-377-9936; fax: 615-661-4042
Specialty: workers compensation
Staff/Facilities
Primary practitioners*1,436
Specialists5,865
Hospitals43
Total Users903,360
Operational date: June 1991.
Service area: Virginia: 49 counties.
**Includes leased providers/facilities.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*1,727
Specialists2,902
Hospitals**39
Service area: Virginia: 112 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Health Care Savings Inc.
4530 Park Road, Suite 110, Charlotte, N.C. 28209; 800-833-8464;
fax: 704-527-0677
Staff/Facilities
Primary practitioners9
Patients/practitioner37
Hospitals1
Users: Group Health
Employer/payer groups10
Employees & dependents405
Total Users405
Service area: Virginia: Greensville County.
See Health Care Savings Inc. consolidated listing under North Carolina.