Payers
How a deduction happens, payer by payer.
Nineteen pages describing mechanisms — fifteen insurers and four government schemes. We publish no rejection rate for any payer, no ranking between them, and no advice on which to avoid — we have not measured any of that, and a number nobody can check is not worth reading.
The mechanism is nearly the same everywhere.
Room caps, pre-authorisation scope and query windows account for most of what gets deducted, whichever name is on the policy. What differs is the cap, the window and the tariff — which is why the fix is your contract, not your choice of insurer.
Government schemes
A scheme claim fails differently. On a private policy the usual outcome is a deduction — the claim is paid, and paid less. On a scheme the usual outcome is an unpayable case: a verification that did not complete, a referral that was never raised, an entitlement period that had lapsed. That difference moves the whole problem upstream, from the billing desk to registration.
Your payer mix, on your own settlements.
We name the clause behind each reduction and you keep the findings, whatever you decide.