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Managed HealthCare Northwest, Inc. is based in Portland, Oregon and is
owned by Legacy Health System and Adventist Medical Center. MHN was
formed December 1, 1988 through the merger of CareMark Services and
Northwest Health, Inc. MHN is an Oregon for-profit corporation.
Service Area
CareMark PPO and MHN PPO represents one of the most broadly based
networks in the greater Portland-Vancouver area including:
Oregon State Counties:
Multnomah, Clackamas, Washington, Columbia,
Hood River, Lane,
Wasco, Yamhill, and Coos.
* Coos county includes 1 hospital and limited physician
access
Washington State Counties:
Clark, Cowlitz, Skamania, and Klickitat.
PPO Panel
The Professional Provider
Network is comprised of 4,757 physicians
and other professionals, including 1228 primary care physicians and represents
80 medical specialties. Of MHN's providers, 69% of the PCP's and 78%
of the specialists are board certified. The panel is currently closed, unless a specific
demographic access or specialty is needed.
The
Hospital Network
is comprised of 18 facilities, including two premier tertiary care (highly
specialized, high technology) facilities: Legacy Emanuel Hospital &
Medical Center, and Legacy Good Samaritan Hospital & Medical Center.
Managed Care Plan Options
MHN’s full spectrum of managed care services can be integrated into
the employer's existing gatekeeper or point-of-service plan design,
whether insured or self-funded. Utilization-Quality Management
services can be provided in a complete package, or Utilization-Quality
Management and Claims Re-Pricing can be purchased separately. There are
currently more than 125,000 members in CareMark PPO and MHN PPO.
Cost Effective
MHN delivers high quality health care by means of stringent physician
credentialing and peer monitoring systems. Costs are controlled by
ensuring care is medically necessary and given in the appropriate setting
- as well as by negotiated provider discounts.
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Products
CareMark PPO Services include:
Hospital and Physician Panel
Medical Management
Re-pricing Network Claims
MHN PPO Services include:
Hospital and Physician Panel
Hospital Panel Only
Physician Panel Only
Re-pricing Network Claims
Medical Management:
Pre-certification of hospitalization and surgery
for medical necessity
Concurrent and retrospective review
Complex case management
CareMark Comp Workers' Compensation MCO
Directories
Please contact the MHN Marketing Department for administrative fees and
other information at (503) 413-5800.
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Health Insurers
Group Insurers
ODS Health Plan (minimum 2)
(503) 228-6554
PacificSource Health Plans (minimum 2)
(503) 699-6561
Individual Insurers
Assurant Health
(800) 884-6875
PacificSource Health Plans
(800) 624-6052
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Third Party
Administrators
A & I
Benefit Plan Administrators, Inc.
(503) 224-0048
Ameriben
Solutions, Inc.
800-786-7930
Administrators West
800-321-2814
Allegiance
Benefit Plan Management, Inc.
(406) 721-2222
Alternative Risk Management
(ARM, Ltd. NW)
503-968-6831
Employee
Benefit Management Services
(503) 274-4447
Health Comp
Administrators
(800) 647-7247
HealthCare Management
Administrators
(800) 869-7093
Kipp & Company
(503) 279-9943
Loomis Benefits West, Inc.
(503) 221-6700
Phillips Administrative Services - Albany
(800) 356-9822
Performance Health Administrators (PHA)
(800) 859-7514
Select Benefit Administrators, Inc.
(888) 598-8908
Trusteed Plans Service Corporation
(253) 564-5611
Western
Benefits, Inc.
(503) 968-2360
William C. Earhart Company
(503) 282-5581
Zenith Administrators
(206) 282-4100
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Side-by-Side PPO
Could your employer clients improve profits by increasing employee
PPO utilization?
Would employees enjoy the opportunity to select family physicians from a second
PPO network?
If so, Managed HealthCare Northwest, Inc. offers the needed flexibility!
MHN will share an employer group with a competing PPO network - for new
business - with no minimum enrollment requirement.
MHN will still require each employee to enroll his/her family in one PPO of
choice. As before, the claims payor reports to us employees who have selected MHN PPO
or CareMark PPO.
The claims payor would pay the monthly administrative fee to MHN for only
those employees who have enrolled themselves and their families in our PPO - and
issues MHN PPO or CareMark PPO I.D. cards (as applicable) to these employees.
If our flexibility can save money and expand access for your clients, please call the Marketing Department at (503) 413-5800. We can
also be reached by e-mail at the following addresses:
Jody Ordway - Sales Manager
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Reciprocal
PPO Arrangements
National PPO's
Beech Street Corporation / CAPP CARE
1-949-955-6245
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Value Added Services
Administrative
| Provider Relations
Consultants |
Experienced, cross-trained staff
Assist with physician selection
Identify network
services |
| Marketing Consultants |
Experienced, insurance licensed staff
Supply bid analysis, geo
access and references
Assist with enrollment and
employee health fairs
Complimentary PPO savings
reports |
| Optional Medical Management
Services |
Licensed, professional RNs and MDs
Detailed Bill Review
Medical Case Management
Group Health
Workers'
Compensation
Advisory Medical Necessity
review |
Network
| 4,757 Physicians and other
professionals |
Stringently credentialed, peer monitored
Multi-lingual availability |
| 1228 Hospitals |
Community owned
JCAHO accredited
Complimentary health education
Community philanthropy |
| Urgent Care Facilities |
20 Conveniently located |
Communication
| Receptionist |
Personal call direction |
| Local phone |
(503) 413-5800 |
| Toll free phone outside
Portland area: |
1-800-648-6356 |
| Voice Mail |
24 hour |
| E-mail access |
All staff |
| Bulletins |
Quarterly for customers and brokers |
Directories
| Directories and shipping |
Complimentary
Same day delivery available
Annual drop-shipment of newest directory direct from the printer to payors
and employers
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| Website |
Printable, on-line listings |
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Broker Bulletins
Winter
2007
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