Leading the Industry in Innovation

Healthesystems is a specialty provider of innovative medical cost management solutions for the workers’ compensation industry. Our diverse suite of services includes a leading pharmacy benefits and clinical management program as well as a prospective adjudication solution for managing ancillary medical services.  Leveraging our powerful technology, clinically-based outcomes management expertise and enhanced workflow automation tools, we provide clients with flexible programs that reduce the total cost of medical care while increasing the quality of care for injured workers. 

Industry Pioneers

As a privately owned, stand-alone organization, we are afforded the flexibility to quickly adapt to changes in the complex workers' compensation industry.

Our executive leaders consist of highly respected industry pioneers in the workers' compensation pharmacy management and claims industry. This diverse team leverages their extensive cross-functional experience to develop innovative solutions for managing pharmacy benefits and ancillary medical services. 

 Healthesystems provides:

> Comprehensive drug utilization reviews on all point of service, paper and mail order prescription transactions.

> Patient-centered reviews using evidence based standards of therapy to identify appropriate drug therapies.

> Identification and analysis of brand drug prescriptions suitable for converting to generic alternatives.

> A physician outreach program focused on performing peer-to-peer communication.

> Prescription regimen review and data analysis for pain management evaluations.

> Customized medication plans including client defined formularies, program rules and workflow.

> Prospective adjudication of ancillary medical services.

> Web based software tools and claims workflow automation technology.

> A 24/7 Help Desk providing assistance to pharmacies, adjusters and injured workers. 

> A Pharmacy network with more than 59,000 locations including major pharmacy chains.

> A Mail Order Pharmacy program that increases network penetration and provides additional savings.