Zero to Revenue: Innovating Workers’ Comp Care Management
Our client wanted to deliver best-in-class workers’ compensation services at a lower cost. Six months later, we helped them double their billing output.
The Client
A startup in the workers’ compensation field, our client envisioned high quality specialty case management — delivering the right care, at the right time and at a lower cost. Founded by industry veterans, our client leveraged deep industry expertise to enter the market with a higher-than-average network penetration.
The Business Challenge
Recognizing the inefficiencies within case management workflows, the client saw an opportunity to develop a specialty network solution for case management. Their goal? To provide top-tier workers’ compensation services at lower costs for patients and payers, leveraging an expansive, high quality PPO network. However, they were running against the clock. With their competitors already established in the industry, the client needed to quickly enter the market to become a strategic player.
Pivotal to their success was a strong technology infrastructure. The client was lean by design, outsourcing specialized capabilities to commercial vendors they trusted. Though this ensured quality and consistent service, they still needed robust IT support to take their product to market.
Acting as their go-to technology advisor, X by 2 conducted a comprehensive technology assessment, developed a product implementation roadmap and implemented a seamless billing workflow, exceeding expectations under budget and within an impressive 6-month timeframe.
The Business Impact
- IT Agility & Security
Built a technology footprint to withstand short- and long-term operational adjustments.
- Go-Forward Strategy
Developed a capabilities roadmap, outlining a future expansion and maturation timeline.
- Speed to Market
Quickly aligned leadership and IT to establish market-ready, best-in-class practices.
The Work
Under an accelerated timeline, X by 2 advised in vendor selection, established an architectural and infrastructural vision and implemented an MVP, prepping our client to impact the market.
In approximately 4 to 6 weeks, X by 2 developed a roadmap for the client’s MVP technology infrastructure, interviewing business stakeholders to understand enterprise goals, opportunities and the desired future state. Through this exercise, the team landed on a series of core capabilities needed to support business functionality, case management and the client’s non-risk PPO solution offerings.
It was key to establish a secure, scalable foundation to get our client’s product off the ground. X by 2 architects, bringing decades of industry expertise to the technical analysis, packaged their vendor recommendations and proposed architecture into a comprehensive go-forward strategy, including a project timeline and cost estimates. Aligned with the project scope, direction and agile approach, the client asked X by 2 to move forward with implementation.
The implementation phase targeted provider management, case management and claims re-pricing and PPO network workflows. X by 2 architects built out the client’s organizational infrastructure on Azure Cloud, performing load testing to easily scale up and manage thousands of claims per hour. Once established, they then built a user-friendly bill monitoring dashboard, integrated a bridge for provider networking and contracting and rolled out a PPO pricing solution. In tandem, the X by 2 team worked toward establishing security measures and ensuring the product remained industry compliant.
This platform helped the client visualize the full impact of their low-cost bill repricing services quickly and clearly, well positioning them to onboard the network they needed and begin selling their product to prospective clients.
The Business Outcome
By project end, X by 2 delivered a working MVP to drive claims repricing as a core business functionality. Within months of completing the project, the IT infrastructure helped the client establish a strong PPO network, become an industry player and welcome their first client. Since, they have more than doubled their monthly billing output.
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X by 2 was an incredibly responsive partner that knew our domain — their team felt like part of ours right away. We met expectations and delivered under budget; that’s something to be celebrated.