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Claim Submission Delay Benchmark

February 18, 2020 / 6 Comments / in benchmarks / by Chip Hart

Paul Vanchiere and I have spoken often about looking into "claim submission delays" when consulting with practices about their billing challenges.   Ultimately, we are interested in narrowing that gap as much as possible for obvious reasons - slow claims are unpaid claims in my experience.

There is some trickiness involved with measuring this concept.  How do we count visits that happen on the Friday afternoon of a long holiday weekend - are they all going to be submitted at least 3-4 days later (answer: yes)?  Are we distinguishing between the time between the visit and when the physician approves the chart or coding for the billing department (answer: no)?   Are we isolating visits that might have global periods or taking into account bundled claims, like hospital visits (answer: no)?  Are we counting only clean claims (answer: no)?

The bottom line, as with all of my benchmark exercises, I just want a quick and dirty number that anyone can calculate.  Igor fired up the number cruncher and looked at few million claims and simply measured the difference in time between when the service occurred and when it was first billed.  And the results are enlightening.

Screen Shot 2020-02-13 at 11.49.42 AM (1)

What we have here is a picture of the delay between the work and the submission of the claim across millions of pediatric claims.  You can see that 6.3% of the claims took five days to submit.  Or, if you do math in your head, 63.8% of our clients' claims were submitted in three days or fewer.

Of course, this doesn't show us how individual practices perform, it's just the results across all practice.  Here's a quick picture of how individual practices perform using their average submission delay:

delay (1)

What do we learn?  ~80% of our clients submit their claims within four days, on average.  We have a surprising number who average one day or even same day results!  The practices in the long tail at the right are usually special circumstances (retired, after-hours clinics, etc.).  

What do you think?  Where are you on these graphs?

Tags: benchmarks

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