This month, one of our newer doctors—a real stickler for accuracy—asked us to send them last quarter's debt report.
I almost did a double take. In three years of running FreshClaim, this was the first time we'd had that request. Most doctors just follow along on the app and can see our returns in real-time, but being new, I suppose this particular client had not thought about how to navigate our in-app progress indicators yet.
For context, their onboarding was not the smoothest. They'd just broken from their previous billing service, and had accumulated months of claims which they neglected to tell us about - over 400 claims from five months of work.
Things were messy. Fund registrations had ground to a slow trickle at the health funds, delaying our ability to have the correct electronic links. One fund took a full 6 weeks to update their systems to reflect his new billing details, a far cry from their usual 6 working days. A fee update from the MBS had meant almost all the claims needed adjustment to old amounts or risk rejection from incorrect pricing. And of course, being backdated claims, not all the patients medicare and health fund details were current requiring a higher than normal number of manual corrections for membership details.
This was, essentially, a true stress test for our system at high volume while we kept our usual customer base of around 2 thousand claims per month clicking over smoothly.
Our process involves multiple steps before, during and after a claim to ensure payments. If our process works, every claim should pass. We allow around 0.3% in our process that may simply not be eligible for a claim for irreconcilable reasons - patient has quit their fund, irreconcilable item numbers (claiming a surgical assist claim on a surgical item that doesn’t support a claim….etc…)
Anyway, I jumped on the system, sorted their claims by date, and printed off the PDF report (they could have done this themselves, but to be fair, they're new and unfamiliar with the user website).
The summary read:
July 1 to September 30th (Q1 2025-2026 FY)
301 claims submitted
296 payments received
5 payments pending—all five were WorkCover/TAC (who take weeks to pay) - approved.
And there it is. That's the true beauty of our system. Speed, volume, accuracy, effectiveness.
296 claims, all paid. Five to come, approved. No rejections.
I glanced over the report - that was a satisfying moment for me personally!
It’s our team’s goal of a better way to get claiming done. Fuss free (for the user), efficient and accurate for us, and the main thing - payment outcomes to be unsurpassed in completion rate.
What I saw here was a busy doctor who had months of stored up claims, and they have now discovered a way to get their claims completed in record time, payments that arrive within days of lodgement, and virtually no claim left unpaid. Now that their historical claims have been entered and cleared, the ongoing work is smooth. We don’t really hear from them. I can see each week they put in their claims, and the status board reads - submitted, approved or paid. One or two claims sit on our side with tiny red “escalated” status which means our team is tidying up a small detail to ensure approval…that’s it.
I started this journey of building FreshClaim with the knowledge so many billing services, and often, many office staff think (justifiably) that we earn well, so who’s going to miss a few claims here or there…except, that’s not the way I believe we should operate. Supermarkets don’t expect us to scan “most” of the items in our basket, tradies don’t charge us “roughly” the quoted amounts, and the banks don’t round down their interest rates to make life neater!
It's not that I personally don't know this—I check regularly to ensure we meet these self-imposed standards, and we're constantly innovating to make the admin process more efficient for our staff. But I couldn't have asked for a better way to see our work validated. 296/296 is a good testament- made even more impressive in that it was 296 aged claims, with higher error rates, pricing issues, time-related external inaccuracies, and a far higher rate of manual error management.
My idea was that from a little app in their hand, a couple of seconds of work to lodge a claim, to getting paid for all of my work. No lost income, prompt payment cycles, straight to my bank. That was my goal, and it remains my goal of every customer we on-board.
That's what we're most proud of.
That’s the validation we find when we put ourselves in the shoes of our customers. The performance indicators we see overall sound great….99.7% claim success, 70 hour median time to payment etc…but printing out that report ? Knowing what it was like for them to send in hundreds of claims in very little time, and knowing the end summary sits at zero unpaid claims is pretty much where we want our system to be!