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1997 DIRECTORY OF MANAGED CARE PROVIDERS

Reprints

Nebraska
Ameritas Managed Dental Care
5900 "O" St., Lincoln, Neb. 68510; 402-467-1122; fax: 402-467-7883
Specialty: dental
Staff/Facilities
Primary practitioners7,627
Specialists100
Users
Employer/payer groups20,717
Employees & dependents368,724
Ownership: Ameritas Life Insurance Corp.
For profit.
Service area: Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Illinois, Indiana, Kansas, Massachusetts, Maryland, Michigan, Missouri, North Carolina, Nebraska, Nevada, New Jersey, New York, Ohio, Oklahoma, Rhode Island, Texas, Virginia, Vermont, Wisconsin.
Services: Dental. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates charges by predetermined fees per procedure per area; is compensated by employers/payers, insurers; charges by percent of premium.
UR: Preadmission review, retrospective review, hospital bill audits. UR provided by the PPO.
Officers: Lawrence Arth, chairman/CEO; Kenneth Louis, president/COO; David Moore, executive vp-group/pension; Kenneth VanCleave, vp-group managed care/partnering; Karen Darrah, assistant vp-managed care/marketing.
Contact: Karen Darrah.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353;
fax: 714-727-1319
Staff/Facilities
Primary practitioners198
Specialists598
Hospitals12
Users: Group Health
Single coverage6,637
Family coverage25,972
Employees & dependents66,373
Users: Workers Compensation
Single coverage1,064
Total Users67,437
Operational date: 1992.
Service area: Nebraska: 26 counties.
See Beech Street Corp. consolidated listing under California.
BluePreferred
7261 Mercy Road, Omaha, Neb. 68180-0001; 402-390-1800; fax: 402-392-2141
Staff/Facilities
Primary practitioners1,211
Board-certified73%
Specialists1,953
Hospitals90
Pharmacies300
Users: Group Health
Employer/payer groups400
Single coverage43,730
Family coverage53,447
Employees & dependents227,874
Users: Workers Compensation
Total Users241,459
Ownership: Blue Cross & Blue Shield of Nebraska.
Operational date: December 1987.
Not for profit.
AAHC/URAC accreditation status: Health Network Standards.
Service area: Colorado*; Iowa*; Kansas*; Nebraska: statewide; South Dakota*; Wyoming*.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. 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 second surgical opinion. UR provided by the PPO.
Officers: Steven A. Lorenzen, senior vp-managed care networks; Dr. Morris B. Mellion, chief medical officer/senior vp-health care policy; Jerome A. Dworak, senior vp/chief marketing officer; Karen A. Hollingsworth, vp-benefits department; Charles D. Dabney, director-professional/provider relations.
Contact: Charles D. Dabney, 402-390-1877.
**Serves contiguous counties to the Nebraska border.
CNA Managed Care-Nebraska
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners987
Hospitals11
Service area: Nebraska.
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*514
Board-certified45.3%
Patients/practitioner2
Hospitals8
Service area: Iowa: Pottawatamie County; Nebraska: Burt, Butler, Cass, Dodge, Douglas, Holt, Lancaster, Sarpy and Washington 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 practitioners53
Service area: Nebraska: 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 practitioners656
Board-certified95%
Specialists1,944*
Hospitals10
Service area: Nebraska.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
Exclusive Healthcare Inc.
10250 Regency Circle, Omaha, Neb. 68114; 402-255-1658; fax: 402-255-1665
Staff/Facilities
Primary practitioners260
Board-certified74%
Patients/practitioner307
Specialists900
Hospitals11
Pharmacies318
Primary care locations127
Users
Employer/payer groups275
Single coverage14,892
Family coverage17,548
Employees & dependents74,614
Medicare4,204
Medicaid4,677
Total83,495
Revenues
First-half 1997$59,403,193
1996$87,287,904Parent: Mutual of Omaha Health Plans Inc.
Licensed in: Iowa, Kansas, Missouri, Nebraska, Nevada, Texas.
NCQA one year accredited.
Model type: IPA.
For profit.
Service area: Iowa: Harrison, Mills and Pottawattamie counties; Nebraska: Cass, Douglas, Sarpy, Saunders and Washington counties.
Services: General medical, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 2% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: William Ketner, president; Jacque Alt, executive director; Roy Harman, director-marketing; Dr. Gil Wright, medical director; Marcia Friesen, Medicare/Medicaid manager.
Contact: Troy King, 402-255-1673.
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 practitioners137
Specialists707
Hospitals5
Total Users31,561
Operational date: June 1991.
Service area: Nebraska: 41 counties.
**Includes leased providers/facilities.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
HMO Nebraska
10040 Regency Circle, Suite 300, P.O. Box 241739, Omaha, Neb. 68124-5739; 402-392-2800; fax: 402-392-2761
Staff/Facilities
Primary practitioners386
Board-certified79.5%
Patients/practitioner88.7
Specialists1,211
Hospitals24
Users
Employer/payer groups142
Single coverage5,783
Family coverage8,450
Employees & dependents34,241
Total34,241
Revenues
First-half 1997$18,069,145
1996$35,531,879Parent: Blue Cross & Blue Shield of Nebraska.
Operational date: September 1985.
Federally qualified.
Licensed in: Iowa, Nebraska.
Model type: Group/IPA.
Service area: Iowa: Fremont, Harrison, Mills and Pottawattamie counties, parts of Cass, Monona, Montgomery, Page and Shelby counties; Nebraska: 47 Eastern and Central counties.
Services: General medical, vision, prescription drug, mental health, durable medical equipment. 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: 39% of members are enrolled.
Non-federally qualified programs.
Individual enrollment is allowed.
Officers: Maxine E. Crossley, COO; Dr. Timothy D. Ranney, medical director.
Contact: Carolyn J. Groth, director-HMO marketing, 402-398-3613.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*396
Specialists681
Hospitals**17
Service area: Nebraska: 59 counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.