HCS has built a solid network of participating physicians, network professionals, ancillary providers, ambulatory surgery centers (ASCs) and hospitals to meet our customers’ needs. We have contracted and credentialed our network participants to ensure they not only meet our business standards, but comply with all the qualifications and regulatory requirements associated with providing medical services in the workers’ compensation and personal injury protection (PIP) arena.
Therefore, we require that network participants use in-network physicians, freestanding ASCs and hospital-based, same-day surgery centers when referring patients for treatment of a work-related injury, as outlined in the HCS Physician and Health Care Professional Office Manual. Network participants are required to follow these guidelines when treating claimants, whether medical care is coordinated by HCS case managers or by case managers based at our clients’ offices.
Similarly, network participants treating PIP claimants must suggest the use of network physicians, facilities and other network professionals because of their expertise in the treatment of musculoskeletal injuries. Claimants who have PIP coverage can maximize their PIP benefits by using HCS network participants at HCS-contracted network rates. Under New Jersey PIP regulations, patients have the right to seek medical care of their own choosing. However, it is important to inform them of their options and how the HCS network might be of an overall benefit to them.