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Participating Physicians and Other Health Care Professionals

The policies and procedures contained in this section of the website provide information concerning your responsibilities as a participating physician or other health care professional.

HCS network participants are selected based on their training, commitment and experience in workers’ compensation and personal injury protection (PIP) medical care treatment and management. If you have questions concerning any aspect of your participation in the HCS network, please call 1-800-985-7777.

HCS participating physicians and other health care professionals have agreed to follow HCS guidelines and policies. This manual does not modify the terms of your Participation Agreement with HCS. In the event of any conflict between your Agreement and the information contained in this manual, the terms of your Agreement will prevail.

It is expected that you establish the same type of positive relationship with the claimants served by HCS and its clients as you would with any other patients. In addition, it is expected that you provide claimants with insights and education regarding their diagnoses and treatment plans.

This will help them understand their role and accountability in the recovery process — an important element in achieving optimal treatment and return-to-work outcomes or return to optimal productivity under (PIP). Although workers’ compensation focuses on attaining maximum medical improvement and return to work, HCS wants to avoid any misunderstanding that you are the “company” physician or health care professional.

Should a medical condition exist that is not related to an applicable workers’ compensation- or PIP-covered injury, it is advisable that you refer the patient to his/her family physician. Payments for treatments arising from nonwork-related illnesses or injuries are the responsibility of the patient and/or his/her health insurance carrier.

As a condition of participation with HCS, physicians and other health care professionals have specific responsibilities as defined in their respective contractual agreements, which include adherence with HCS policies and procedures, including those specified in this manual. We encourage you to review your agreement and to contact our office if you have questions or need clarification.