Outcomes Focused Network

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Outcomes Focused Network
Our Outcomes Focused Network consists of specialists, physical therapy professionals and surgical centers that closely collaborate to deliver medical care to injured workers using evidence-based medical guidelines. The Outcomes Focused Network keeps patients engaged in their medical treatment so that they understand their condition and play an active role in their recovery. The program helps to decrease the use of opioid medications, resulting in faster recovery without the high cost and high risk of addiction.

Delivering Efficiency, Precision and Results
Our services enable workers’ compensation and automobile insurers to achieve excellent financial results. Our medical directors are practicing doctors, and HCS is NCQA-accredited. More than 97 percent of New Jersey hospitals are in our network and our network is directly contracted, not leased. HCS also has an extensive ambulatory surgery network and is contracting with affiliated anesthesia groups.

Services include:

  • Automated data analytics
  • Dedicated account management
  • Dedicated IT, with fully integrated, proprietary systems
  • Legal representation of provider contracts and rates
  • Medical bill processing, tracking, monitoring and payment
  • Resolution of provider inquiries
  • Systems and data security under Horizon Blue Cross Blue Shield of New Jersey
  • Web-based client access

Customized Services

HCS also offers industry-leading services to increase network utilization and efficiency for insurance company nurses and adjusters. These services include:

  • Appointment scheduling and tracking services
  • Network participant look-up tool
  • Extraction of key data elements from medical reports
  • Medical management through the Outcomes Focused Network participants
  • Referral program
  • Treatment/return-to-work tracking within specific diagnosis and associated national medical guidelines