Helping You Provide The Best Possible Care
Information for Providers
An injured employee’s return to health is everyone’s goal, and building strong relationships with medical providers goes a long way in accomplishing this. At Zenith, we work with providers to help ensure providers are experienced in workers’ compensation and understand the care and services needed for industrial injuries.
As a Zenith network provider, you are part of a team that will work together to help injured employees obtain appropriate care to help achieve an optimal medical outcome. Zenith’s team of medical management professionals is available to work with you, the employer, and the injured employee to optimize communication, care, and return-to-work.
Use these links to locate other network providers and service vendors.
Zenith’s online directory tool is used to find medical providers who participate in networks we utilize. In the tool, you can search by Address, Name, or Region.
Providers are included in the applicable network only for locations listed. Treatment obtained at locations not listed in the network is considered out-of-network. Out-of-network treatment is subject to denial where permitted by law. The online directory tool also provides information on providers available in other select states. If you need to locate a provider for a state that isn’t included in our tool, call Customer Service at 800-440-5020 and ask for Provider Relations.
This online directory is for reference only and is not authorization for treatment. Zenith claims specialists should be contacted for referral approval. Please contact Customer Service at 800-440-5020 and ask for Provider Relations or contact Provider Relations by email at firstname.lastname@example.org.
Directory information is updated monthly and subject to change without notice. While we strive to maintain up-to-date provider demographics, Zenith doesn’t warrant the accuracy of directory information or the quality of the medical care. Please contact us at 800-440-5020 if you find a discrepancy in the directory.
Custom Networks for California and Texas
Providers listed for California participate in the Zenith Medical Provider Network (ZMPN) and providers listed for Texas participate in the Zenith Health Care Network (ZHCN). Injured employees are required to obtain treatment from a provider in the ZMPN or ZHCN. Failure to treat in network may result in denial of payment. Referrals for treatment must also be made to providers within the applicable network. See the Policies and Procedures section for additional information and requirements.
California only: Zenith utilizes the Zenith Pharmacy Network and does not reimburse for office dispensing except in limited circumstances. Please see California ZPN Pharmacy Lookup for more information.
A chiropractor cannot be the injured employee’s treating physician after the injured employee receives 24 chiropractic visits, unless Zenith has authorized additional visits in writing. The term “chiropractic visit” means any chiropractic office visit, regardless of whether services performed involve chiropractic manipulation or are limited to evaluation and management. If medical treatment is required after 24 chiropractic visits, a new physician who is not a chiropractor must be selected.
New Jersey and Pennsylvania Only
Zenith uses the Horizon Casualty Services, Inc. workers’ compensation network in New Jersey and certain contiguous counties in Pennsylvania when the injury arises in New Jersey but treatment is rendered by a Horizon provider in Pennsylvania. We use the Prime Health workers’ compensation network in Pennsylvania. If you participate in both networks, the following shows the order contracts will be applied:
- The Prime Health contract applies to claims arising in Pennsylvania when treatment is rendered by an Prime Health participating provider in Pennsylvania;
- The Horizon contract applies to claims arising in New Jersey when treatment is rendered by a Horizon participating provider and treatment is provided either in New Jersey or in one of the contiguous Pennsylvania counties.
Zenith uses ancillary vendors to provide certain medical services to injured employees including services such as diagnostic imaging, durable medical equipment, physical therapy, and translation services. Texas and California only: Reimbursement may be denied for services provided outside of the applicable network. Providers that are contracted with an ancillary vendor are required to follow that vendor’s processes and procedures for the arrangement of services as well as billing. Failure to comply with the vendor’s processes may result in reimbursement being denied as out of network.