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Choosing a Workers’ Comp PPO Network

Understand the questions to ask when choosing a network of doctors and facilities to treat your employees injured on the job – not all PPOs are the same!

By Ilene Wachs, President, Horizon Casualty Services, Inc.

New Jersey ranks #2 in the nation in cost of workers’ compensation insurance (California is #1) and almost half of that cost relates to medical expenses. Therefore, effectively managing medical costs is key to a successful workers’ compensation program.

The starting point for containing medical costs is selection of the best-in-class Preferred Provider Organization (PPO) network of physicians, hospitals and other health care professionals. The PPO must offer contracted provider reimbursement rates that reflect deep discounts. This ensures that the highest quality medical care can be delivered to insureds at the lowest possible cost.

Horizon Casualty Services, Inc. (HCS), a subsidiary of Horizon Blue Cross Blue Shield of New Jersey provides workers’ compensation and personal injury protection (PIP) PPO services throughout New Jersey, processing over $2.4 billion in medical bills annually.

With that scale, and with clients representing 47 percent of all workers’ compensation premiums in New Jersey and 67 percent of all the insured vehicles in the state, HCS has deep insights into the nuances that can help carriers and companies choose the right PPO network.

Here are five tips for making the right workers’ comp PPO network decision: