🇦🇺Australia

Delayed Billing from PA Approvals

2 verified sources

Definition

Without prior approval, services cannot proceed or be billed, tying up cash flow in private practices reliant on insurer payments.

Key Findings

  • Financial Impact: AUD 10,000-20,000/month delayed receivables per mid-sized practice (high AR days)
  • Frequency: Per authorisation cycle (days to weeks)
  • Root Cause: Sequential manual submission and insurer review without automation

Why This Matters

The Pitch: Physicians face 2-4 week payment delays from manual PA. Automation enables real-time approvals and faster cash collection.

Affected Stakeholders

Billing Staff, Practice Principals, Accounts Receivable Managers

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 Authorisation Processing Delays

12 hours/week per physician at AUD 200/hour = AUD 2,400/week lost revenue opportunity

Patient Treatment Delays from PA

AUD 5,000-10,000 annual revenue loss per physician from patient churn (2-5% of patient base)

Illegal Additional Charges on Bulk Billed Services

AUD 5,000+ fines per violation (typical statutory penalty range)

Manual Documentation Delays

20-40 hours/month per GP at AUD 100/hour (AUD 2,400–4,800/month lost capacity)

Produktivitätsverlust durch manuelle PDMP/RTPM‑Abfragen und Dokumentation

Logic-based estimate: 5–10 hours of lost billable time per prescriber per month due to manual PDMP checks and documentation, equating to roughly AUD 1,000–3,000 per prescriber per month (assuming AUD 200–300 effective hourly revenue), or AUD 12,000–36,000 annually.

Manual Denial Management

10-20 hours/month at AUD 50/hour = AUD 6,000-12,000/year per practice

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