Medical Management Services

This client is the nation’s leading provider of complex and catastrophic medical management in the workers’ compensation industry. The company provides acute and ongoing catastrophic and complex case management services for traumatic brain injuries, spinal cord injuries, amputations, burns, wounds and chronic pain. The client achieves five times better medical outcomes while lowering total costs by more than one-third.

CLIENT CHALLENGES

The client had finally reached a point where it was no longer able to rely on Excel workbooks for annual planning for a growing volume of clients and products.

  • Multiple steps were required to calculate bookings, revenue, cost of revenue, paid claims, billings and collections.
  • Quarterly re-forecasts were required for increased accuracy of cash flows, revenues and costs. Gathering, consolidating and modeling data was not possible using Excel.
SENTURUS SOLUTION

Senturus implemented a centralized, web-based planning system based on the input of expected claim referrals from each sales region at the client and product level. It is now possible to forecast and plan for revenue, cost of revenue and cash flow accounts while factoring complexities that closely follow the business operational processes.

  • Referrals are converted into expected signed cases based on historical ratios kept at the client category and product level.
  • Bookings are extended by average product costs that are calculated by client category. Revenue and cost-of-revenue (COR) is spread monthly using historical seasonality indices.
  • Paid claims, billings and collections are computed and spread monthly from bookings and seasonal patterns for each of the three accounts.

The new planning system led to significant improvements in accuracy of bookings, revenue, cost of revenue, paid claims, billings and collections.

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