Auto Claim Management Assisted by Predictive Analytics
Unique to CBI, Predictive Analytics (PA) is a standard part of our claims process that when
combined with our clinical expertise and best care practices helps:
Determine rehabilitation Reduce complicating
options that yield the
best outcome and
optimize spend
 You to be efficient and accurate: know
factors like litigation
within 24 hours who is DTPR or AAIB,
how long it should take the claimant
to recover, the cost of care
Establish a guide for
measuring progress
at key intervals in
the claim
HOW THE CLAIM PROCESS WORKS
TIMELINE
24
ASSESSMENT
Hours
DTPR
%
80
of cases
%
20
of cases
Hi Marie,
For J. Doe (3432) here is:
1. AB2 report
2. PA Report with
We’ll be calling today to
review treatment options.
CBI Central Intake
Hi Marie,
For J. Doe (3432) here is:
1. AB2 report
2. PA Report with
CBI Central Intake
AAIB
· Cost
· # treatments
· Discharge rec
· Cost
· Services
· treatment team
· # treatments
· Discharge rec
}
CBI DETERMINES CARE PLAN:
1. Claimant completes intake
form with questions about
their injury (pain, sleep, mood)
2. CBI clinician completes
Assessment
3. Data is loaded into CBI
Predictive Analytics system
4. P REDICTIVE ANALYTICS
determines if claimant is DTPR
or AAIB, cost, # of treatments,
discharge recommendation
5. Customized rehabilitation plan
is created (with input from
clinician and PA)
}
30
PROGRESS
• Are we achieving objectives?
• Are client needs changing?
• Are we on track with predictions?
96%
Hi Marie,
The treatment for J. Doe (3432)
is on-track according to prediction.
CBI Central Intake
of cases
discharge in
DTPR
Hi Marie,
Mr. J. Doe (3432) has completed
treatment. I have attached the final AB4
report. Here is a summary of the claim.
Return to work/life
60
Days
Outcome VS Prediction
Closed within DTPR
Closed within DTPR
$1,200
$1,100
19 treatments
19 treatments
RTW-F
RTW-F
97% satisfied with care
Please call if you have any questions.
CBI Central Intake
}
80%
Follow-up on
status of rehab
and client
participation
Please call us if you have any questions.
DISCHARGE
• Have we achieved the expected
outcome?
•H
ave claim cost and timing
objectives been achieved?
•A
re we successfully managing
legal risk?
of cases
stay on-track
}
If client status/needs change:
Progress email will say: file is not
on-track according to prediction
and include recommendations.
Treatment team will have contacted
CM prior to email with reasons and
to discuss options/share
recommendations or discuss extension.
Days
100
POST DISCHARGE
Follow-up on outcomes,
monitor total claim spend
Days
To make a referral that has the advantage of predictive analytics or to ask us a question, please contact:
MVA Central Referrals t: 1.888.341.4993 f: 1.855.217.0159 e: [email protected]