Claim Settlement Cycle Time (Medical)
This PDF report includes benchmarking data (in a visual, chart-based format), an comprehensive KPI definition, characteristics of high performers and technical details on measuring Claim Settlement Cycle Time (Medical). Purchase and download this easy-to-understand, presentation-ready report immediately to compare performance levels, set attainable performance targets, and push towards best-in-class performance for this KPI.
What is Claim Settlement Cycle Time (Medical)?
The average number of days required to process, adjudicate and pay out a single approved medical insurance claim, measured from the time that the claims is submitted by the healthcare provider until the claim payment has been made to the provider.
Why should Claim Settlement Cycle Time (Medical) be measured?
Claim Settlement Cycle Time (Medical) measures the average number of days required for a health insurance payer to process and pay out a medical insurance claim. Extended medical claims settlement cycle times create issues for both health insurance payers and healthcare providers (e.g., physicians, hospitals, pharmacies, etc.). For health insurance companies, long cycle times increase costs, reduce Claims Department employee productivity, and can negatively impact relationships with healthcare providers and policyholders. On the side of the healthcare providers, extended claims settlement times can impact their ability to meet short term financial obligations (i.e., pay the bills) and greatly increase administrative costs. In many cases, cycle times can be reduced by establishing and enforcing inbound claims data quality, processing claims payment electronically (e.g., through electronic data interchange, or similar) and maximizing the number of claims that are auto-adjudicated.
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