🇦🇺Australia

Patient Treatment Delays

3 verified sources

Definition

Insurers like Allianz and Bupa require pre-auth forms submitted 5 days before treatment; DVA forms must be complete or returned, blocking treatment start and causing patient drop-off.

Key Findings

  • Financial Impact: AUD 2,000-5,000 per lost implant case (avg implant revenue); 5-10% client churn from delays
  • Frequency: Every high-cost procedure (implants, orthodontics) requiring insurer/DVA pre-approval
  • Root Cause: Mandatory lead times (5 days submission) and form rejection loops without digital submission

Why This Matters

The Pitch: Australian dentists lose 5-10% of major procedure clients annually due to pre-auth wait times. Automation speeds approvals to same-day, retaining revenue.

Affected Stakeholders

Dentists, Patients, Practice Administrators

Deep Analysis (Premium)

Financial Impact

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Current Workarounds

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Methodology & Sources

Data collected via OSINT from regulatory filings, industry audits, and verified case studies.

Evidence Sources:

Related Business Risks

Prior Approval Delays

10-20 hours/month per practice on form handling and resubmissions; equivalent to AUD 1,000-2,000/month at AUD 100/hour dentist rate

Claim Denial Risks

AUD 500-5,000 per denied major procedure claim; 6-week SA claim processing window

Fines for Non-Compliance with Dental Regulations

AUD 5,000-50,000 per breach in fines and legal costs; 20-40 hours per audit preparation

Penalties for Using Non-TGA Approved Dental Devices

AUD 10,000-100,000 fines per violation; inventory write-offs of 5-10% stock value

Costs from Informed Consent and Record-Keeping Failures

AUD 5,000-30,000 per legal claim or compensation; 10-20 hours per incident documentation

Einnahmeverluste durch abgelehnte oder gekürzte Zahnleistungsansprüche wegen fehlerhafter CDT-Codierung

Quantified: Typischerweise 2–5 % des jährlichen Versicherungsumsatzes als nicht realisierte Erlöse; bei einem Praxisumsatz von AUD 1 Mio. entspricht dies etwa AUD 20.000–50.000 pro Jahr an verlorenen oder gekürzten Erstattungen.

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