Inefficient medical billing costs more than you think
Most practices compare FreshClaim's billing fee against the hours their own staff spend on billing — but the real cost of in-house billing runs far higher. Four hidden losses are missing from that comparison. This page names them, adds them up, and measures them against FreshClaim's 2.85% fee.
Four hidden losses
Each one is real money you do not collect. A well-run practice has smaller losses. A busy practice has bigger ones. But no practice can remove them all. To do that, you would need to lodge every claim the same day, spend no staff time on it, and never lose a claim, all at once. Here are the four losses.
Claims that never get entered
Theatre stickers go missing. Claims are forgotten. Claim sheets are lost. The doctor's work was done, but the claim was never entered, because the paperwork was lost before it reached the biller.
Staff time spent on billing
A busy practice spends about 10 hours a week entering claims, fixing mistakes, checking problems, chasing rejected claims, and doing reconciliation and account reporting. At $60 an hour, that is $600 a week. Against about $20,000 of inpatient claims a week, that is 3%. You pay this whether the claim is paid or not.
Slow payment
Every practice waits for the fund to pay. That wait is fixed, and nobody can make it shorter. But most practices add extra days before that, because the claim sits and waits to be sent. At first it is sent tomorrow. Then it slips to the end of the week. Then several weeks. The busier the doctors get, the harder it is to find time for billing. A growing practice can end up 3 to 6 weeks behind. Those extra weeks cost you money, because the cash is not in your account.
Payments never received
Some claims are sent but never paid. Others are rejected or questioned, and no one follows up in time. This risk is now higher. Since September 2025, you have one year to send, fix, or resend a claim. Before, you had two years. There is also a second risk. The fund payment is based on the Medicare payment. If the Medicare claim runs out of time, you lose the fund payment too. You do not just lose part of the claim. You lose all of it.
Loses fewer claims and gets fewer rejections. But this takes work. Staff spend more hours, not fewer, on entering, checking, and following up. So the time cost goes up even as the other losses go down. Better than most, but still far above us.
All four losses, at full size. This is money lost, and none of it shows up on any bill.
FreshClaim sends every claim the same day
FreshClaim sends each claim on the day the work is done. After that, the only wait is the fund. That wait is the same for everyone. No system, no biller, no app can send a claim faster than same day, and none can make a fund pay faster. So FreshClaim is not just a smaller delay. It is the fastest anyone can be. This is the line to compare every practice against.
So the only delay that costs you extra is the time a claim waits before it is sent. A growing practice often falls 3 to 6 weeks behind. Here is what those extra weeks cost.
Cost per day = 10% ÷ 365 = 0.027% a day
Extra wait = 3 to 6 weeks (21 to 42 days)
Extra cost = 0.027% × 21 to 42 = ~0.6% to 1.2%
You cannot fix this by working harder. In fact it gets worse as you grow, because billing is the first thing to slip when the doctors are busy. The fund takes the same time for everyone, including us. The only thing you can change is whether the claim is waiting or already sent. FreshClaim sends it straight away, so there is no extra wait.
About 8% lost, against a 2.85% fee
FreshClaim is an Australian medical billing service for private specialists. It is not an app linked to a separate claiming system — it is one claiming system, with the app built in. We designed the app to get rid of submitting errors, forgotten claims, lost sheets, and other delays. Doctors can submit a claim in just a few seconds, with no complicated form filling. FreshClaim lodges claims the same day and waits only for the fund, the same wait everyone has — the fastest a claim can be paid. The numbers below show what a busy practice loses on top of that. The FreshClaim fee is a flat 2.85% of what you collect — nothing else.
| Cost | Busy practice loses | FreshClaim |
|---|---|---|
| Claims never entered | 1.5% | 0% |
| Staff time on billing | 3.0% | 0% |
| Slow payment | ~0.6–1.2% | 0% |
| Payments never received | 3.0% | 0% |
| Total lost | ~8% | 0% |
| Billing fee (on money collected) | varies | 2.85% |
claims
on billing
waiting
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FreshClaim is the fastest anyone can be, not just a faster option. The better a practice runs its billing, the more it has to spend to get there. And even then, it still costs more than we do.
A 3 to 4 doctor practice
Take a busy practice with 3 to 4 doctors, each billing $1M of inpatient work a year. That is $3M to $4M of claims. Here is the full cost of billing it in-house, against the full cost with FreshClaim. The in-house figure already includes staff wages, so nothing is added twice. We run billing across every specialty we work with.
| 3 doctors | 4 doctors | |
| Claims never entered | $45k | $60k |
| Staff time on billing | $90k | $120k |
| Slow payment | $27k | $36k |
| Payments never received | $90k | $120k |
| Total cost | ~$252k | ~$336k |
| 3 doctors | 4 doctors | |
| Claims never entered | $0 | $0 |
| Staff time on billing | $0 | $0 |
| Slow payment | $0 | $0 |
| Our fee (2.85%) | $85.5k | $114k |
| Total cost | ~$85.5k | ~$114k |
The benefits you cannot put in a table
The money saved is only part of it. When FreshClaim does the billing, your staff get their time back. That time can go to better things, and the practice runs more smoothly. Still weighing up providers? See how to choose a billing service.
Happy doctors
Doctors get paid quickly. Every claim is tracked, so they have peace of mind. Any problem is flagged clearly, so there is never any doubt about where a claim stands. The doctors see their money come in, and they trust the system that brings it.
Free up staff you already pay
The 10 hours a week your staff spend on billing can go to patients, the front desk, and the work that actually needs a person. You are not paying for billing twice.
Less hassle
No chasing lost sheets. No fixing rejected claims. No wondering if a claim was ever sent. The stress of billing goes away.
Better morale
Billing is slow, fiddly work that staff do not enjoy. Take it off their plate and the office is a happier place to work.
A smoother practice
Claims go out on time, money comes in faster, and reports are clear. The whole practice runs better when billing is not the bottleneck.
Medical billing costs, answered
- How much does medical billing really cost a specialist practice?
- More than the fee. On top of whatever a billing service charges, a busy practice loses around 8% of revenue to claims that are never entered, staff time spent on billing, slow payment, and claims that are never paid. FreshClaim is a flat 2.85% of what you collect, with those four losses designed out.
- Is it cheaper to do medical billing in-house or to outsource it?
- In-house looks free because there is no fee, but the staff time and lost claims add roughly 5–8% of revenue. For a 3 to 4 doctor practice billing $3M–$4M a year, moving to FreshClaim typically keeps $165k–$220k more, because the in-house total already includes the wages you are paying.
- Why do practices lose money on billing without noticing?
- The losses never appear on an invoice. Claims that are never logged, the hours staff spend entering and chasing claims, the cash that sits waiting because a claim was not sent, and claims that quietly time out are all invisible until you add them up.
- How does FreshClaim’s 2.85% fee compare with other billing services?
- Most services charge a fee and still leave the four losses in place. FreshClaim lodges every claim the same day and tracks it to payment, so the fee is the whole cost of billing — not the starting figure.
- What changed with Medicare claim time limits in 2025?
- From 5 September 2025 you have one year to send, fix, or resend a claim, down from two. Because the fund payment is based on the Medicare payment, a claim that times out loses the fund portion too — you lose the whole claim, not part of it.
- How quickly does FreshClaim get claims paid?
- Claims are lodged the same day the work is done. After that the only wait is the fund, which is the same for everyone. Most claims are paid within 70 hours and 100% are completed.
FreshClaim · freshclaim.com.au