Who Are We?
- We are the only 100% African-American, physician owned Health Maintenance Organization (HMO) in the State of Michigan
- The owner, Dr. Augustine Kole-James, is a well-known doctor in Detroit
- He has practiced in Wayne County for thirty years
- We became certified as a Clinic Plan in 1996, as a Qualified Health Plan in 1998 and a licensed HMO in 2000
- We were accredited in January 2007 by the Utilization Review Accreditation Commission (URAC)
Where Are We Located?
- We are located at 3956 Mt. Elliott, Detroit, Michigan
What Prior Experience Have We Had?
- We have been involved in Managed Care Programs with the state since 1996
- first as a Clinic Plan, in Wayne County, then
- as a QHP and currently as an HMO
How Do We Operate?
- We operate within a managed care environment that includes an organization and structure designed to provide for, or arrange for:
- comprehensive health care services to an enrolled population of members
- member satisfaction
- member rights, and responsibilities, and
- cost management review programs such as utilization review
Who Do We Contract With?
- We contract with participating metro area doctors, physician specialists, urgent care centers, pharmacies, and ancillary providers
- We have a comprehensive network includes:
- Federally Qualified Health Centers
- Primary Care Health Centers
- Doctors organized as a partnership and a professional corporation
- The primary care providers (e.g. family or general practitioners, internists, pediatricians, and obstetricians/gynecologists) have
an economic and medical responsibility for managing all referrals for specialty, ancillary and hospital services