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1997 DIRECTORY OF MANAGED CARE PROVIDERS

Reprints

South Dakota
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353;
fax: 714-727-1319
Staff/Facilities
Primary practitioners3
Users: Group Health
Single coverage1,692
Family coverage5,951
Employees & dependents15,379
Users: Workers Compensation
Single coverage1,064
Total Users16,443
Operational date: 1990.
Service area: South Dakota: Lawrence, Minnehaha, Pennington, Union and Yankton counties.
See Beech Street Corp. consolidated listing under California.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; fax: 619-278-1262
Staff/Facilities
Specialists7
Hospitals6
Service area: South Dakota: Brown, Clark, Clay, Davison, Douglas, Edmunds, Grant, Gregory, Hamlin, Hughes, Kingsbury, Lake, Lawrence, Lincoln, McCook, Minnehaha, Pennington, Spink, Turner, Walworth and Yankton counties.
Services: General medical, mental health, workers compensation, ancillary services.
See CCN 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 practitioners2
Service area: South Dakota: statewide.
See ChiroSource Inc. consolidated listing under California.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners146
Board-certified99%
Specialists994*
Hospitals23
Service area: South Dakota.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
DAKOTACARE
1323 S. Minnesota Ave., Sioux Falls, S.D. 57105; 605-334-4000; fax: 605-336-0270
Staff/Facilities
Primary practitioners515
Board-certified75%
Patients/practitioner50
Specialists585
Hospitals64
Pharmacies215
Primary care locations200
Users
Employer/payer groups900
Single coverage6,894
Family coverage5,303
Employees & dependents25,604
Total25,604
Revenues
First-half 1997$20,195,000
1996$34,147,000Parent: S.D. State Medical Holding Co. Inc.
Operational date: May 1986.
Licensed in: South Dakota.
Model type: IPA.
For profit.
Service area: South Dakota.
Services: General medical, vision, prescription drug, mental health, chiropractic, home health, durable medical equipment. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 100% of members are enrolled.
Officers: Robert D. Johnson, CEO; Kirk J. Zimmer, senior vp; Dr. William Rossing, vp/medical director; Barbara Smith, vp-internal operations; Thomas Nicholson, vp-sales/marketing.
Contact: Thomas Nicholson.
First Choice of the Midwest Inc.
617 W. Algonquin Ave., Suite 200, Sioux Falls, S.D. 57104; 605-332-5955; fax: 605-332-5953
Staff/Facilities*
Primary practitioners255
Board-certified98%
Patients/practitioner135
Specialists369
Hospitals21
Users: Group Health*
Employer/payer groups100
Single coverage7,350
Family coverage13,650
Employees & dependents34,650
Total Users*34,650
Ownership: Mike Hagert.
Operational date: August 1997.
For profit.
Service area: Iowa: 21 counties; Minnesota: 30 counties; South Dakota: 66 counties; Wyoming: Albany, Campbell, Cargon, Converse, Crook, Goshen, Johnson, Laramie, Natrona, Niogara, Platte, Sheridan and Weston counties.
Contracts with Associates for Health Care nationwide; Ethix Northwest in Washington; CCN-Medview in California, Florida and Texas.
Services: General medical, mental health, vision, workers compensation. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers, providers, insurers, TPAs; charges flat fee per employee.
UR: Standard procedures excluding preadmission review, hospital bill audits, outpatient service predetermination. UR provided by outside contractors.
Officers: Mike Hagert, president.
**As of 10/15/97. Product operational as of 8/1/97.
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 practitioners169
Specialists686
Total Users22,543
Operational date: May 1996.
Service area: South Dakota: 51 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*14
Specialists30
Hospitals**2
Service area: South Dakota: 21 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
Hospitals13
Users: Group Health
Employer/payer groups1
Employees & dependents55,005
Service area: South Dakota: 27 counties.
**Practitioner network not yet established.
See MultiPlan Inc. consolidated listing under New York.
Mutual of Omaha of South Dakota and Community Health Plus HMO Inc.
3904 Technology Circle, Suite 104, Sioux Falls, S.D. 57106; 605-361-9591;
fax: 605-361-9593
Staff/Facilities
Primary practitioners60
Board-certified90%
Specialists130
Hospitals3
Pharmacies80
Primary care locations11
Users
Employer/payer groups15
Employees & dependents3,934
Total3,934
Revenues
First-half 1997$2,152,900
1996$3,272,116Parent: Mutual of Omaha Health Plans Inc.
Operational date: June 1995.
Licensed in: South Dakota.
Model type: Group.
For profit.
Service area: South Dakota: Lincoln, McCook, Minnehaha and Moody counties.
Contracts with Diversified Pharmaceutical Services for prescription drug.
Services: General medical, vision, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 12% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Jennifer Sampson, executive director; Dr. James Coughlin, medical director; Michael Jareske, financial director; William B. Jetter, marketing director; Greta Vaught, vp-network operations.
Contact: Jennifer Sampson.
Mutually Preferred PPO
Mutual of Omaha Plaza, Omaha, Neb. 68175; 402-351-4255; fax: 402-351-2999
Staff/Facilities
Primary practitioners89
Specialists143
Hospitals2
Service area: Clay, Lincoln, McCook, Minnehaha, Moody, Turner, Union and Yankton counties.
See Mutually Preferred PPO consolidated listing under Nebraska.
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 practitioners1
Service area: South Dakota: cities of Aberdeen and Yankton.
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
Specialists10
Hospitals3
Users: Group Health
Employer/payer groups8
Employees & dependents8,667
Total Users8,667
Service area: South Dakota.
See National Preferred Provider Network Inc. consolidated listing under New York.
ProAmerica Managed Care
1250 E. Copeland Road, Arlington, Texas 76011; 800-523-3669; fax: 817-436-5391
Staff/Facilities
Hospitals1
Users: Group Health
Service area: South Dakota: Northeastern region.
See ProAmerica Managed Care consolidated listing under Texas.
TLC Advantage L.L.C.
3900 W. 53rd St., P.O. Box 89310, Sioux Falls, S.D. 57109-1008; 605-361-5702; fax: 605-361-4121
Staff/Facilities
Primary practitioners798
Board-certified95%
Specialists1,301
Hospitals43
Pharmacies254
Users: Group Health
Employer/payer groups187
Employees & dependents49,604
Users: Workers Compensation
Employer/payer groups1,297
Single coverage*70,000
Total Users*110,000
Ownership: Edward E. Arshem; RAS Investments Inc.; Dobbs Inc.
Operational date: June 1994.
For profit.
Service area: Alabama, California, Delaware, Florida, Illinois, Iowa, Kansas, Kentucky, Minnesota, Missouri, Montana, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Wisconsin, Wyoming.
Services: General medical, dental, vision, prescription drug, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by discount off customary rates; is compensated by employers/payers; charges flat fee per employee, by percent of savings.
UR: Standard procedures. UR provided by outside contractors.
Officers: Edward E. Arshem, president/CEO; Ralph E. Johnson, director; Joe Dobbs, director.
Contact: Kristi Brandt.
**Estimate.