DMAA | DM Directory Add New Profile

Add New Profile

Please note: DMAA reviews all DM Directory submissions for appropriateness before posting. Please allow 3-5 business days for review. You cannot edit or delete your profile after submission without DMAA assistance. Use our Feedback Form (choosing "Web site" as the topic) to request assistance with your directory listing.

1. About Your Company

Fields designated by a * must be completed in full for the submission to be accepted.

Company Information:

Company Name:*

Company Status:*

Publicly Held Privately Held Non-Profit

Address:*

Address 2:

City:*

State/Province:*

Zip/Postal Code:*

Country:*

Web site:

(Note: Please include http:// at start of address.)

Primary Contact:

Name:*

Title:*

Phone:*

E-Mail:*

Fax:*

Management Team:

CEO:

VP/Dir. of Marketing:

VP/Dir. of Sales:

COO / Operations:

Medical Director:

Name:

Phone:

Fax:

E-Mail:

Company Statistics:

Years in DM:*

<1 1-3 4-6 7-10 10+

Full Time Staff:

2003: 2004: 2005: 2006:

Part Time Staff:

2003: 2004: 2005: 2006:

Patients Enrolled in DM Programs:

2003: 2004: 2005: 2006:

DMAA Status:

Is your organization a DMAA member?:*

Yes No

Would you like to be sent information on DMAA Membership?:

Yes No

Type of Company:*

Geographic Regions Served:*

DM Company - Full Service
DM Support/Specialty Services
PBM
Pharmaceutical Company
Home Care
Consulting
e-Health
Other

National (Contintental US)
Northwestern US
Southwestern US
Central US
Northeastern US
Southeastern US
International

2. Your Company's Programs

Services Provided:*

Client Types:

Predictive Modeling
Patient Segmentation
Internet Support - Patient
Internet Support - Physician
Patient Behavior Change Programs
Remote Patient Monitoring
Nurse Supported Inbound Patient Call Center
Nurse Supported Outbound Patient Call Center
Patient Education Materials
Depression Screening
Health Risk Appraisal
Clinical Practice Guidelines
Home Care Support
Outcomes Measurement Surveys
All Of The Above
Other or Unlisted

Commercial Health Plan
Employer
State Employee Benefit Program
Medicaid Health Plan
State Medicaid
Medicare Health Plan
Medicare FFS
Veterans Affairs Administration
TriCare
Department of Defense
Union
DM Company
Pharmaceutical Company
Other

Description of Program or Services [400 Words Maximum] (If "Other" selected above, please describe.)

Major Clients [Please List]

Outcomes Data

Availability of Outcomes Data:

Economic Clinical Humanistic [Quality of Life, Etc.]
Patient Satisfaction Physician Satisfaction

Is Outcomes Data Published?:

Yes No In Process

Note: DMAA will publish outcomes reports on its website for member organizations.

Program Accreditation*

Accreditation	NCQA	URAC	Joint Commission
completed
In process
Certification	NCQA	URAC	Joint Commission
completed
In process

3. Disease State Information (To be completed by Full Service DM Companies Only)

Disease States (Please specify the status of services your company offers.)

Disease	Currently Offered	Being Added in next 12 Mos.	# Patients Enrolled (Optional)	Certified	Accredited	Accred/Cert In Process
Allergy / Allergic Rhinitis
Alzheimer's Disease
Anti-coagulation
Arthritis
Asthma
Child Health / Neonatology
Chronic Kidney Disease
Congestive Heart Disease
COPD
Coronary Artery Disease
Crohn's Disease
Depression
Diabetes
ESRD
Frail Elderly
Gastroesophageal Reflux
Hemophilia
Hepatitis B / C
HIV / AIDS
Hyperlipidemia
Hypertension
Lower Back Pain
Maternal Health
Migraine
Oncology
Osteoporosis
Other
Parkinson's Disease
Pre-ESRD
Rare Diseases
Smoking Cessation
Weight Management


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