01
Eligible claims never submitted
In a study of Calgary specialists over seven years, 91.8 percent of eligible fee for service claims were actually submitted. Roughly eight services in every hundred were never billed at all.
Modelled payback by encounter volume
Every figure on this page is modelled, without guarantee. The baseline review replaces these assumptions with the physician's own numbers.
Full-time GP reference case
The reference setup uses 317 encounters a month, $350,000 in gross billings and the $2,390 Standard annual plan.
For context, average annual billings were $299,640 per Alberta family physician before overhead, across 5,268 fee for service family physicians. Alberta overhead ran about 27 percent, the highest in the country. Source: Canadian Family Physician, 2018 to 2019 data.
Assumptions
Encounters a month317
501,600
Estimated recovery per encounter$5.00
112
Show subscription cost
Added billings a year
$19,020
Share of gross
5.4%
Matching plan
Standard
Subscription cost
$199.17 a month*
Return
8.0x
Net gain a year
$16,630
Payback encounter
478
Payback month
1.5 months
*Billed annually at $2,390, which is 17 percent less than paying monthly.
General practice selected. Every specialty is included in the plan price.
Claim failure evidence
02
Diagnosis coding errors
Accuracy on the medical condition recorded was 87.8 percent. About one claim in eight carried a diagnosis coding error.
03
Available modifiers and premiums omitted
Neither figure counts the modifiers and premiums available on submitted claims. That layer is not measured in the literature, and it is where VitalisBill does most of its work.
CMAJ Open, Calgary specialists, 2002 to 2009. Hospital based, and directional rather than current.