In the fast-paced world of healthcare, the financial health of a medical practice is deeply tied to how quickly claims are processed and reimbursed. One of the most commonly asked questions by healthcare providers is: “What’s the average turnaround time for claims in a medical billing company?” Understanding this timeline is essential, as delays can directly impact cash flow, staffing decisions, and overall operations. In this article, we’ll explore the factors that influence claim turnaround time, industry benchmarks, and how a top-tier provider like Thrive Medical Billing ensures faster, more accurate reimbursements.
What Does Claim Turnaround Time Mean?
Claim turnaround time refers to the number of days between when a claim is submitted to an insurance payer and when the reimbursement is received by the provider. It’s a key performance metric used to measure the efficiency and effectiveness of a medical billing company.
There are generally two types of turnaround time:
Initial Submission Turnaround: The time it takes for an insurance company to respond to a newly submitted claim.
Total Resolution Turnaround: The total time from submission until final payment, including any re-submissions or appeals for denied claims.
The faster the turnaround, the quicker a practice receives payment—improving revenue cycles and minimizing disruptions to daily operations.
Industry Standards for Claim Turnaround
The average turnaround time in the medical billing industry can vary depending on several factors, including the payer, specialty, and accuracy of the claim. However, here are some general benchmarks:
Clean Claims (no errors): 7 to 21 days
Government Payers (e.g., Medicare, Medicaid): 14 to 30 days
Commercial Insurance Companies: 10 to 25 days
Denied Claims (requiring re-submission or appeal): 30 to 90+ days
These averages highlight why submitting clean, error-free claims is critical—and this is where a skilled medical billing company like Thrive Medical Billing proves its value.
Factors That Affect Claim Turnaround Time
While some delays are outside a provider’s control, many are preventable with the right billing partner. Several variables influence how quickly claims are paid:
1. Claim Accuracy
One of the biggest reasons for claim delays is incorrect or incomplete information. Thrive Medical Billing ensures that each claim is thoroughly checked before submission, including CPT/ICD-10 codes, patient demographics, and insurance details.
2. Payer Type
Government payers like Medicare often take longer than private insurers due to their more complex verification and auditing processes. Thrive keeps track of payer-specific guidelines and timelines to avoid unnecessary slowdowns.
3. Specialty-Specific Requirements
Different specialties face different billing challenges. For example, behavioral health claims may be subject to time-based coding rules, while orthopedic procedures often require prior authorization. Thrive’s specialty-specific knowledge helps streamline claims across all medical fields.
4. Denial and Rejection Handling
Denied claims can extend turnaround times significantly. A proactive medical billing company must not only resolve these quickly but also identify patterns and prevent future occurrences. Thrive’s dedicated denial management team works to reduce these delays.
5. Claims Submission Method
Electronic claims are processed much faster than paper claims. Thrive Medical Billing uses advanced billing software that ensures secure, same-day electronic submissions to all major payers.
How Thrive Medical Billing Improves Claim Turnaround
At Thrive Medical Billing, reducing claim turnaround is a top priority. Through proven processes, robust technology, and expert staff, they consistently deliver faster payments and higher collection rates. Here’s how they do it:
Streamlined Claim Scrubbing
Before any claim is submitted, Thrive uses advanced claim-scrubbing software to check for errors or omissions. This process helps prevent rejections at the clearinghouse or payer level, ensuring a higher first-pass acceptance rate.
Real-Time Eligibility Checks
Thrive verifies patient eligibility and benefits in real-time before the service is provided. This minimizes denials due to inactive policies or uncovered services, both of which can delay payments.
Proactive AR Management
Accounts receivable (AR) follow-up is key to improving turnaround. Thrive’s AR specialists monitor unpaid claims daily, initiate follow-ups, and escalate aging accounts before they become a problem.
Data-Driven Reporting
Thrive provides clients with custom reports showing the average turnaround time per payer, per claim type, and per service category. These insights help providers understand where delays occur and how to fix them.
Dedicated Account Managers
Every client at Thrive Medical Billing is assigned a dedicated account manager who monitors claim flow and keeps the client informed. This personal attention leads to faster issue resolution and smoother communication.
Average Turnaround Times at Thrive Medical Billing
Thanks to their streamlined processes and technology-driven approach, Thrive Medical Billing regularly outperforms industry averages. Their average turnaround times are:
Clean Claims: 7–14 days
Medicare Claims: 10–20 days
Commercial Insurance Claims: 10–18 days
Denied Claims (Appealed Successfully): 20–40 days
These figures demonstrate Thrive’s commitment to maximizing cash flow and minimizing disruptions for their clients.
Real-World Example: Cardiology Practice Revenue Surge
A cardiology clinic in Michigan partnered with Thrive Medical Billing after experiencing inconsistent reimbursements and long delays—sometimes waiting over 45 days for payment.
“After switching to Thrive, our average turnaround dropped to just under 14 days for most claims. The difference in cash flow was immediate, and we were finally able to forecast income reliably and plan for growth.”
The clinic also reported a 22% reduction in claim denials and a 30% increase in monthly collections—all within the first three months.
The Link Between Turnaround Time and Cash Flow
Fast claim processing doesn’t just mean quicker payments—it means better overall financial health. Here’s how reduced turnaround times improve your practice:
More Predictable Cash Flow: Helps with budgeting, payroll, and operating expenses
Less Stress on Staff: Minimizes time spent chasing unpaid claims
Higher Patient Satisfaction: Fewer billing errors mean fewer patient complaints
Stronger Financial Planning: Timely reports support strategic decisions
By working with a performance-focused medical billing company like Thrive Medical Billing, practices experience these benefits firsthand.
How to Evaluate a Billing Company’s Turnaround Performance
If you’re shopping for a billing partner, make sure to ask the right questions:
What is your average turnaround time for clean claims?
How do you handle denied or rejected claims?
Do you offer real-time reporting on claim status?
What tools do you use to ensure claim accuracy?
Can you provide turnaround data broken down by payer?
Thrive Medical Billing answers these questions confidently, with data to back up every claim.
Conclusion
The average turnaround time for claims in a medical billing company can greatly influence your practice’s financial success. While the industry standard ranges from 10 to 30 days, efficient companies like Thrive Medical Billing often deliver reimbursements in as little as 7 to 14 days for clean claims.
By focusing on accuracy, proactive denial management, and payer-specific workflows, Thrive Medical Billing consistently outperforms the competition. Whether you run a solo practice or a multi-specialty clinic, improving your claim turnaround time is not just possible—it’s achievable with the right billing partner.
If you want faster payments, fewer denials, and reliable financial forecasting, it’s time to consider Thrive Medical Billing—the medical billing company trusted by clinics nationwide.
