a16z|Jul 30, 2026 15:29
Data from @camberhealthhq shows a clinic can do everything right and still not get paid on time.
The same insurer pays up to 2.09x as much for identical service depending on the state.
28% of claims get approved and then sent back over a code, a form, a missing field.
Each round trip returns less money:
- A claim paid on the first submission recovers 96% of what's owed
- By the fourth, it's 23%, often landing months after the treatment happened
Denials get the most attention, yet the median clinic gets denied on just 3.3% of claims. The margin dies after the approval.
"The demand was never the hard part. Getting paid for it was."
The Hidden Math of Behavioral Health w/ Camber data: https://www.a16z.news/p/the-hidden-math-of-behavioral-health(a16z)
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