2-3%
Process-related losses
2-3%
Unrecovered aged debt
6-8%
Real cost including fees
The fee on your invoice is only part of what you’re paying. Claims that are never submitted, rejected and not recovered, or quietly written off add up to a hidden cost that most specialists never see. These four questions will help you understand what your billing service is actually delivering. Then, you can calculate the true cost of your billing.
How do you confirm that every claim I generate has actually been submitted?
Most billing services process in bulk and users assume everything goes through. But for even the most diligent services, claims can fail silently due to system errors, missing fields, or transmission failures. Doctors describe painstaking processes of marking off claim diaries and waiting forever for checks from services to ensure every claim, every sticker, and every sheet gets entered. At FreshClaim, our app logs each claim and is synchronised with our admin system so there is never any loss from transmission to processing.
Benchmark: ~2 in every 100 claims never submitted
What percentage of submitted claims are rejected due to data or coding errors?
Transcription errors are common. The more manual the process, the higher these are. The majority of billing services struggle with data accuracy because of the software they are forced to use. An 8-10% critical error rate is not uncommon. At first pass, this means more of your fees go into correcting simple human error, so payment failures and claim delays become routine. FreshClaim designed its software from the start to minimise transcription error, with built in checks that occur before submission. Higher first-pass approval achieved in less time mean more of your fees go into resolving your claim rejections, not fixing slip-ups.
Benchmark: ~8 in every 100 submitted claims
What percentage are rejected for clinical or eligibility reasons outside your control?
Some rejections are unavoidable - a patient’s Medicare eligibility has lapsed, a fund doesn’t cover a particular item, or a clinical rule blocks the claim. These are outside the billing service’s control. At FreshClaim we know this number is vanishingly low - around 0.3% or 3 per thousand. If your billing service is telling you your aged debts are higher than this, there’s something wrong.
Benchmark: ~2%, FreshClaim (KPI) - 0.3%
Of all rejected claims, what percentage do you successfully recover and get paid?
Rejections are inevitable. What matters is what happens next. A billing service that simply writes off rejected claims is costing you money. A service that offers a low initial fee often chooses to walk away from rejection management as it costs more than the fees you pay for a successfully reconciled claim. Some pass the rejections back to you for correction, effectively charging you the whole percentage to act as a simple transmission service. FreshClaim’s fees cover claim management through to payment. If a claim is eligible, we get it paid.
Benchmark: Doctors who switch to FreshClaim tell us their aged debts regularly sit around 2-3%.
Your true costs
Take all the losses we’ve described above - the base fee, plus all the lost claims = your true billing cost. For many doctors, it is somewhere like 2-4% plus another 2-4%.
Benchmark: Attrition % + effective fee %
Why these questions matter
Most billing services only report on what they’ve processed. They don’t report on what they’ve missed, lost, or written off. Asking these questions forces transparency and gives you the data you need to compare services on an equal footing.
FreshClaim · Australian inpatient & outpatient billing
We built FreshClaim to solve these problems at the source.
FreshClaim tracks and logs every claim from the moment it’s generated to the moment it’s paid. We never write off a claim without your explicit approval, and we follow up on every rejection until it’s resolved or you decide to stop. Every claim has a full audit trail, and you can see exactly where your money is at any time.
2.85%
Fee
100%
Tracked to paid
2.85%
Cost, no surprises
$3,150
Saved per $100k