Percentage of Claims Completed Within 15 Days
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 Percentage of Claims Completed Within 15 Days. 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 Percentage of Claims Completed Within 15 Days?
The number of medical insurance claims adjudicated within 15 days of receiving the claim from the healthcare provider divided by the total number of claims adjudicated by the payer over the same period of time, as a percentage.
Why should Percentage of Claims Completed Within 15 Days be measured?
The Percentage of Claims Completed Within 15 Days measures the volume of medical claims adjudicated by the insurance company within 15 days of reception, which is a highly reasonable timeframe within which to complete a medical claim. A high percentage of claims NOT completed within 15 days can speak to various inefficiencies within the claims processing function: poor inbound claims data quality (e.g., missing information, etc.), a large number of claims processed manually and poor claims intake and routing processes can increase claims cycle times and costs. 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.
Download a Sample Percentage of Claims Completed Within 15 Days
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