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Healthesystems – Pharmacy & Ancillary Benefits Management and
Clinical Reviews Services

About Our Company

Healthesystems is a specialty provider of innovative solutions to help workers' compensation insurance payers manage the utilization and costs of prescription drugs and ancillary medical services provided to injured workers. Our client tailored services include a leading Pharmacy Benefits Management (PBM) Program, comprehensive Clinical Review Services and a revolutionary Ancillary Benefits Management (ABM) Program for managing ancillary medical service transactions.

Founded by workers’ compensation and pharmacy benefit management industry experts, our leadership staff understands the many complexities and obstacles payers encounter in our industry. As our customers' strategic partner, our approach is to proactively develop and present solutions which minimize the amount of work required of them and maximize the opportunities to save money.  As an independent, privately owned company we have the flexibility to quickly adapt to the ongoing changes in the workers' compensation industry and continually exceed our customer's expectations.

As one of our Core Values, our focus on innovation is a key characteristic differentiating our company, products and services in the market. Innovation was the catalyst for starting our business and is what continues to drive our great success.  The constant development of new ideas to help our customers overcome industry challenges is one of the hallmarks of our client relationships.  Developing those ideas into successful solutions is how our programs achieve unmatched results.

Our powerful technology platform supports a proven, scalable infrastructure to manage the largest customer environments and incorporates flexibility for client-unique set up parameters.  Our focus on real-time transaction processing facilitates the management of more information, faster.  Combining this technology with the expertise of our outcome-focused, PharmD clinical staff elevates the function of our programs beyond acting solely as a provider network, and expands to a process that reduces the total cost of medical care. In fact, our solutions and groundbreaking ideas have set new standards for the delivery of these services within the medical management arena.

The results are extraordinary.

Optimized product and service utilization.
Improved claims outcomes.
Increased quality of care for injured workers.
Increased network penetration.

Our customers include some of the largest workers’ compensation payers in the industry. They benefit from our powerful tools including online and real-time access to services, as well as electronic prior authorizations and analytical reporting tools. 

Healthesystems is truly an industry leader — paving a path of innovation in the workers’ compensation medical management arena. Our proven history of performance and extensive market experience produces superior results, advancing the quality and efficiency of medical service management.

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