Not Your Average Workers’ Compensation and Auto PPO 

Horizon Casualty Services, Inc. (HCS), an affiliate of Horizon BCBS NJ (Horizon), is the cornerstone in the management of workers’ compensation (WC) and personal injury protection (PIP) services in New Jersey. Headquartered in Newark, NJ, HCS provides a service that each of us may need to access at some point, but only if faced with an injury in the workplace or in an automobile accident – something that we don’t often consider.   

HCS is a state approved workers’ compensation managed care organization (WCMCO) that offers a comprehensive suite of administrative, provider network and medical management services. These services are designed to achieve the best possible outcomes for injured individuals and a few examples include: 

1. Robust Network and Provider Directory Management: HCS identifies providers with WC and PIP experience and contracts with the services most needed by the injured individual. HCS is contracted with nearly all hospitals and all level 1 and level 2 trauma centers in the State of New Jersey. We identify initial treaters, specialists, physical therapy centers, ambulatory surgical centers, urgent care providers, diagnostic centers and more. Using a proprietary formula, the best providers are highlighted so that clients can rest assured their injured claimants are in the right hands.  

2. Referral Services/Appointment Scheduling: HCS facilitates the referral of claimants to in-network providers to ensure they receive the most appropriate care at the most appropriate cost.  

3. Utilization Management: When appropriate, HCS Registered Nurses work to summarize claimant discharges from hospitals. This process allows clients to have a clear and concise summary to determine next steps for managing the claim.  

4. Monitoring and Evaluating Provider Performance: Registered Nurses continuously monitor and evaluate the performance of providers, as this is crucial to maintaining the quality of care within the network. HCS also offers clients, at no additional cost, access to the Outcomes Focused Network; a highly scrutinized subset of the overall network where each provider is rigorously reviewed by HCS nurses to ensure that they provide quality care, access in-network facilities and provider articulate causation statements.  

Jackie Alonso, President of HCS, has stated “HCS offers unparalleled service and an unbeatable PPO product in the NJ workers’ compensation and auto space. Coupled with our proprietary software, highly skilled and WC/PIP savvy team, and a deep understanding of the marketplace, HCS offers its clients an impeccable product with the deepest network discounts. We work lockstep with our Horizon peers and being backed by the largest healthcare carrier in NJ sets us apart and allows HCS to thrive in the community.” 

Alonso continued, “this [2024] year, we made a concerted effort to get out into the community and have attended multiple fairs and conferences, as both participants and exhibitors. This shift in how we engage with our clients and prospects has allowed us to think more innovatively about how we evolve our products and services. Listening to the voice and feedback from all of our stakeholders and understanding it is about meeting them where they are at. This is how we maintain our impeccable product and showcase it across the region.” 

HCS partners with providers and collaborates with them in the local community which allows clients to experience how a best-in-class WC and Auto PPO should work.  

For More Information 

For more information, email Jed Hoban, HCS Business Development Executive, at Jed_Hoban@HorizonBlue.com or visit or visit https://www.horizonblue.com/horizoncasualty/. 

About Horizon Casualty Services, Inc. 

HCS, an affiliate of Horizon, in business since 1994, is a leading PPO in New Jersey WC and PIP. HCS has a 100% direct-contracted provider network that includes almost all New Jersey acute care hospitals. The network delivers significant overall savings and, with its deep focus on precision, an extremely low appeals rate. Its PPO results, combined with its Healthcare Value Strategy and Outcomes Focused Network, enable insurers to be the best at delivering quality medical care to claimants at the right cost — clearly a win-win for all. HCS and Horizon are independent licensees of the Blue Cross and Blue Shield Association. 

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