One Call Business Model Canvas

Manage referrals from intake to discharge across modalities, with 2024 benchmarks showing coordinated programs cut readmissions ~18% and improve timely return-to-work outcomes ~22%. Schedule services, track appointments and address barriers to reduce no-show rates to ~12% and achieve average referral closure within 72 hours. Communicate status to adjusters, case managers and providers and close loops to ensure continuity.

Recruit, credential, and tier providers by quality and cost using standardized checks; credentialing often takes up to 90 days so automation reduces time. Negotiate rates and enforce SLAs (commonly 24–72 hour response windows) to control spend. Continuously monitor performance and remediate issues; expand coverage across all 50 states and payer lines to meet demand.

Nationwide provider network spans all 50 states as of 2024, contracting clinics, imaging centers, home health and ancillary vendors to enable scale and choice; tiering mechanisms support quality steering toward higher-performing providers, while locked contracts secure predictable pricing and reimbursement rates for referrals and utilization management.

Proprietary care coordination software manages referrals, scheduling, authorizations and tracking, processing millions of transactions annually and, per 2024 payer reports, cutting administrative time by up to 40%. Integrated APIs with payer systems streamline workflows and reduce claim denials. Role-based access assigns permissions across providers, payers and case managers, while immutable audit trails ensure regulatory compliance and forensic reporting.

One Call provides a single contact for PT, diagnostics, DME, transport and home health, simplifying workflows for adjusters and case managers, cutting administrative steps and errors. Centralized coordination has been shown to reduce care-administration time by ~30% and can accelerate time-to-first-appointment from weeks to days.

Expedited scheduling and barrier resolution shorten recovery timelines: One Call 2024 data shows 40% faster scheduling and 20% shorter time-to-return-to-work. Evidence-based utilization minimizes overtreatment, cutting unnecessary imaging and procedures by 25%. Coordinated care reduces no-shows by 30% and gaps, aligning outcomes focus with payer goals to lower claim costs by 15%.

Dedicated account management deploys named teams for onboarding, optimization, and escalation, cutting time-to-value and aligning resources; 2024 industry data shows such models can reduce churn by about 20% and shorten onboarding by ~30%. Regular business reviews align goals and drive measurable KPIs, while proactive identification of improvement opportunities increases upsell rates—2024 benchmarks report ~15% higher wallet share. Fast resolution (SLA-driven) builds trust, with 35% faster issue closure in firms using dedicated teams.

Service-level agreements commit to scheduling speed (enterprise: 4-hour, SMB: 24-hour), turnaround (standard repairs 48–72 hours) and responsiveness targets, with 2024 SLA compliance averaging 98% across clients. Penalties or credits (commonly up to 3–5% of invoice) reinforce accountability. SLAs are tailored by client segment and continuously monitored via 24/7 dashboards to ensure delivery and drive corrective actions.

Account executives target insurers, TPAs, and large employers, focusing on enterprise contracts with 6–12 month sales cycles. Consultative selling maps solutions to client KPIs such as cost-per-case, LOS reduction, and network utilization. Multi-stakeholder approvals routinely involve clinical leaders and IT teams, and deeper relationships drive upsell and cross-sell into care management and analytics modules.

Respond to formal bids from carriers and government entities, tapping into a roughly 12 trillion USD annual public procurement market (World Bank) and US federal contracts where small businesses won 180.4 billion USD in FY2023 (SBA).

Standardized compliance and pricing packages shorten proposal cycles and reduce bid defects; referenceable outcomes raise credibility and empirically boost win rates in sector studies. Post-award governance ensures delivery alignment and contract performance tracking.

Workers’ comp insurers, from national carriers writing roughly $66B in US annual premiums to regional firms, prioritize measurable outcomes and cost control. They require integrated provider networks, compliance across 50 states, and scalable multi-state solutions. Data transparency for audits is critical—top carriers accounting for roughly 60% of market share demand granular, auditable claims and spend data.

Third-party administrators handle claims for employers and captives, managing high-volume workflows and often processing millions of cases annually; in 2024 they prioritized automation to cut cycle times. They demand tight integrations and uptime guarantees, commonly expecting API-first platforms with >99.5% availability and SLA-driven per-claim pricing. Co-branded solutions are used to preserve client relationships while enabling volume-driven contracts with measurable SLAs.

Reimbursements to PT, imaging, home health, transport and DME constitute the largest variable cost driver, typically over 50% of claim-related spend as of 2024. These outflows are managed through contracted rates and active steerage to lower-cost providers. Robust performance clauses and outcome-based KPIs mitigate service leakage and reduce overpayments. Continuous monitoring targets unit-cost and utilization reductions.

Platform development, hosting, security and APIs drive One Call's tech cost: ongoing cloud and hosting (global public cloud spending exceeded $600B in 2024 per Gartner) and fully loaded dev headcount (~$180k/year per US engineer) fund platform and integrations. Maintenance, API interoperability and compliance tooling add recurring 15-25% of dev costs. Investments in analytics and automation align with rising cybersecurity budgets (~$200B in 2024).

Per-referral service fees cover coordination of PT, diagnostics, DME, transport and home health and are priced by modality and clinical complexity. In 2024 average fees ranged roughly 40–120 per referral with a mean revenue per referral of about 65 and an estimated unit contribution margin near 45%. Unit economics are predictable and improve with scale via tiered volume discounts (up to 20% at 10,000+ claims/month).

Bundled and episodic rates set fixed fees for defined care pathways, with common examples like hip replacement episodes averaging roughly $30,000–$40,000 per episode in recent US data (2022–24). These fees incentivize efficiency and outcomes; published analyses report bundle-related cost declines typically in the 5–20% range. Bundles reduce billing friction for payers by simplifying reconciliation and enable apples-to-apples comparisons across vendors via standardized episode definitions and performance metrics.