In our last post we discussed the inner workings of medical cost projection. As you may recall, an MCP is a robust review of existing facts, potential complications and long-term projections that requires an exhaustive amount of research, preparation and critical assessment. In this post we are going to touch on successful tips for addressing complexities intrinsic to large loss claims that MCP must also be address. Some of these complexity factors include but are not limited to:

  • The need to settle claims from an undocumented worker
  • Injury necessitates pain management therapy that can include high medication utilization and result in escalating medication costs and the need for pain pumps, spinal cord stimulators, etc.
  • Multiple co-morbidities (e.g. diabetes, heart disease, multiple infections and respiratory infections) cause complications.
  • Treatment includes ongoing and frequent physician visits among various providers
  • Ongoing treatment and claim results in periodic reserve increases

At ANS, we actually match the complexities of each case to the relevant expert knowledge and experience of our network of RNs. This high level expertise allows us the advantage of providing specific recommendations that no one else would consider that achieve improved quality of life and financial savings. But that alone is not enough- to be accurate and reliable in the face of so many complexities, a MCP must include an extensive and comprehensive review of all its moving parts including but not limited to:

  • accident or injuries experienced by the injured worker
  • prior medical history
  • current and prior medical treatment
  • co-morbidities
  • age health status
  • life expectancy

Another important piece is the use of valid and reliable health cost data from which to base any findings. At ANS our experts always conduct an in-depth analysis of potential areas of exposure and potential savings using expert sources of evidenced based medical and cost data. Our medical cost projection professionals do all the prep work and analysis that achieves improved quality of life and financial savings in large loss claims.

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