Perda de Receita em Reembolso de Planos de Saúde
Definition
Claims submission to private insurers for alternative therapies often fails due to non-compliance with plan-specific rules, leading to denied reimbursements despite SUS covering some alternative treatments.
Key Findings
- Financial Impact: R$500-2.000 per denied claim; 10-20% of sessions unbilled (logic: 25% use private plans with strict rules)
- Frequency: Per claim cycle (monthly)
- Root Cause: Incompatibility between clinic invoicing and insurer requirements for alternative medicine
Why This Matters
The Pitch: Clínicas de medicina alternativa no Brasil perdem R$20.000/ano em reembolsos negados. Automação de submissão padronizada recupera essa receita.
Affected Stakeholders
Gestor Financeiro, Atendente de Faturamento
Deep Analysis (Premium)
Financial Impact
Financial data and detailed analysis available with full access. Unlock to see exact figures, evidence sources, and actionable insights.
Current Workarounds
Financial data and detailed analysis available with full access. Unlock to see exact figures, evidence sources, and actionable insights.
Get Solutions for This Problem
Full report with actionable solutions
- Solutions for this specific pain
- Solutions for all 15 industry pains
- Where to find first clients
- Pricing & launch costs
Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Fraudes em Cobrança Indevida de Terapias Alternativas
Rejeição de NF-e por Serviços de Acupuntura e Naturopatia
Atraso no Recebimento por Verificação Manual de Claims
Indenizações por Falhas em Consentimento em Pesquisas Clínicas Alternativas
Suspensão de Direitos por Fraude em Cobrança de Membresias
Perda de Receita por Cadastros Incompletos de Pacientes
Request Deep Analysis
🇧🇷 Be first to access this market's intelligence