For many clinics the biggest debtor is not a patient. It is the insurers and the Social Health Authority (SHA). When claims are slow, rejected or never chased, a busy clinic can look profitable on paper and still struggle to pay staff and suppliers.
Why claims matter more than sales
You earn the income on the day of the visit, but the cash arrives weeks or months later. Payment delays to health facilities have been in the news throughout 2026. Every rejected claim is money you have already spent on drugs, consumables and staff time. Managing claims is managing cash.
Where claims usually bounce
- No preauthorisation for a procedure that needed it.
- The patient's cover was not active on the day of treatment.
- Missing signatures, referral letters or supporting documents.
- Charges above the payer's agreed rates.
- Claims sent after the payer's submission deadline.
Know how old your claims are
List every unpaid claim by payer and by age. Each age band tells you what to do next.
| Age of claim | What it usually means | What to do |
|---|---|---|
| 0 to 30 days | Normal processing | Confirm the payer received it and it is complete |
| 31 to 60 days | Slowing down | Call the claims desk and answer any queries |
| 61 to 90 days | At risk | Escalate and ask for a written status or rejection reason |
| Over 90 days | Probably stuck | Resubmit, appeal or set it aside in the accounts as doubtful |
Five things to do this month
- Check cover and eligibility at reception before treatment. Collect the patient's share of the bill at the visit.
- Record every claim as money owed by that payer on the day of the visit, not on the day it is paid.
- Submit claims within days, complete and with every supporting document.
- Review the age list every week. When a payer pays in bulk, match the payment to individual claims so short payments are spotted and followed up.
- Know what share of income comes from each payer and plan staff, rent and supplier payments around your slowest payer, not your fastest.
Want a clear view of what each payer owes you?
We set up claims tracking and monthly reporting for clinics, so you know what is owed, by whom and for how long.
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