🇦🇺Australia

Unbilled Sessions Beyond Visit Caps

2 verified sources

Definition

Billing software features emphasise bulk invoicing and bill-to reports to capture all billable services.

Key Findings

  • Financial Impact: AUD 150-300 per unbilled session x 10-20 sessions/month = AUD 1,500-6,000/month
  • Frequency: Per patient exceeding standard visit limits
  • Root Cause: No automated alerts for cap extensions requiring medical review

Why This Matters

The Pitch: Occupational therapists in Australia 🇦🇺 leak 5-10% revenue from unbilled extension sessions. Automated approval workflows capture this revenue.

Affected Stakeholders

Billers, Practice Managers, Funding Coordinators

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

Manual Visit Cap Tracking Delays Billing

20-40 hours/month manual tracking at AUD 50/hour = AUD 1,000-2,000/month revenue leakage per therapist

Idle Capacity from Visit Cap Bottlenecks

15-25% lost billable hours = AUD 5,000-10,000/month per full-time therapist

MBS Claim Denials and Audits

AUD 2,100 minimum penalty per false statement + claim repayments

Incorrect MBS Item Selection

AUD 5,000-20,000/year per practice in rejected claims (2-5% of billings)

Übermäßiger Zeit- und Personaleinsatz für manuelle Entlassungsplanung

Logik-basiert: Zusätzliche 10–20 Minuten nicht-wertschöpfende Dokumentations- und Koordinationszeit pro Entlassung × 1.000 Entlassungen/Jahr × durchschnittlich AUD 60/Stunde Personalkosten ≈ AUD 10.000–20.000 direkte Lohnmehrkosten pro Jahr und Einrichtung.

Kosten durch Wiedereinweisungen und Fehlentlassungen wegen unzureichender Entlassungsplanung

Logik-basiert: Wenn nur 1–2 % der älteren Reha-Patienten aufgrund vermeidbarer funktioneller Probleme wieder eingewiesen werden und jede Wiedereinweisung durchschnittlich AUD 5.000–10.000 kostet, entstehen pro 1.000 Patienten jährlich etwa AUD 50.000–200.000 zusätzliche Behandlungskosten, die bei besserer Entlassungsplanung reduziert werden könnten.

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