Revenue Leakage from Unappealed Denials
Definition
Labs lose revenue when denials are not appealed in time; industry data shows hospitals spend billions overturning denials, with partial success leading to leakage.
Key Findings
- Financial Impact: AUD 10B+ annual spend to overturn denials; 20% claims denied, 60% not resubmitted[3]
- Frequency: Ongoing, per denied claim cohort
- Root Cause: Manual workflows, no automated tracking of appeal deadlines
Why This Matters
The Pitch: Medical labs in Australia 🇦🇺 write off AUD 10B+ industry-wide on failed appeals. Automation recovers 75% more claims.
Affected Stakeholders
Accounts Receivable Specialist, Compliance Officer
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 Reimbursements from Denied Claims
High Costs of Manual Denial Appeals
Claim Denials from Coding Errors
Proficiency Testing Rework Costs
Non-compliance with AS ISO 15189 and ISO/IEC 17025
Cost of Poor Quality from Calibration Failures
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