Unbilled Insurance Gaps
Definition
In GapOnly/direct claim processes, vets bill only the gap (e.g., 10-20% of $1,000 invoice), but failures in insurer approval or non-covered items result in revenue shortfalls.
Key Findings
- Financial Impact: 10-20% of eligible invoice ($100-200 on $1,000 bill) per failed direct claim
- Frequency: Per non-GapOnly policy or claim rejection
- Root Cause: Lack of real-time claim approval and policy verification
Why This Matters
The Pitch: Veterinary services in Australia 🇦🇺 leak 10% of invoice value per claim due to gap errors. Automation of claim verification captures full revenue.
Affected Stakeholders
Receptionists, Accounts Receivable
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.
Related Business Risks
Delayed Insurance Reimbursements
Churn from Upfront Payment Barriers
Delayed Accounts Receivable Collections
Unbilled Services and Lost Invoices
GST/BAS Reporting Errors from AR Delays
Superannuation Guarantee Shortfalls
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