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Deductible % vs. Claim Submission Lag Time

What this graphic illustrates: The graph below shows the relationship between the claim submission lag time and the percentage of the allowed amount that was applied to the patient’s deductible responsibilities.

Definitions:

Claim Submission Lag Time – is calculated as the time interval (in days) between the date of service (the date that the procedure was performed) and the date upon which the claim was filed with the insurance plan.

Allowed Amount – represents an insurance plan’s allowed reimbursements for a given procedure. This amount is further allocated to paid amount, co-insurance and deductible.

Deductible Percentage – is calculated by dividing the deductible amount by the allowed amount.

What this means to you: As the claim submission lag time increases, the percentage of the allowed amount that is applied to the patient’s deductible decreases. This suggests that physician practices who submit their medical claims quickly during the first part of the fiscal year will experience increases in their patient-owed receivables. Therefore, it is important that physician offices have patient collection best practices in place to ensure that revenue is not adversely affected.

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