How Long Does AFO Delivery Take? How Long Should It Take?

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By Nathanael Feehan, LPO

We all know that AFOs are the bread and butter of the orthotic profession. They provide the largest volume of our work. But there is much we do not know, which I discovered while trying to determine the national average for AFO delivery time.

I looked at my company's business metrics, asking, "How quickly are we providing AFOs to our patients?" Business metrics, or performance over time, allow us to measure ourselves and determine how we are doing. Are we improving? Are we above or below a national average? Are we meeting our goals? Business metrics are the key to going from a small business run by gut feeling or the seat of our pants to one that is expertly run and profitable. They expose a company's weaknesses and strengths.

To collect information about where we stand in comparison to other companies, I also posed the question to the OANDP-L listserv. Most of the responses gave a range (14-48 days, in one example), which I suspect was because the exact number was either not known or not easily accessible. Two companies were able to tell me the exact number, as well as the length of their subprocesses, fabrication, and how long it takes to obtain insurance approval prior to delivery.

With a small sample size of 25 responses, 17 days from initial evaluation to delivery was the average.

However, 17 days does not give a complete picture since the answers differed so extensively. The replies could be broken down into two general categories: those who completed their patients' insurance billing and received authorization prior to delivery, and those who fabricated and delivered the device first, hoping they would get paid and stay paid.

Those who made sure that payment was guaranteed prior to delivery had an average time from initial evaluation to delivery of 26 days. Those who did not complete the billing first had an average time of ten days to delivery. With more than two and a half times longer to delivery for those who verify insurance, it is obvious that fabrication of the device is not what is slowing delivery in care of patients. Twenty-one days was the shortest turnaround time for those who verify payment before delivery.

This area needs to be further explored, and it shows that compared to other industries O&P has some growing to do in measuring our processes. Nobody can tell how they stack up against any standard of care because there is none. For businesses to do well, they must know exactly how they are doing in comparison to similar companies.

In my opinion there needs to be a national database of metrics that O&P companies can measure ourselves against. National averages would allow us to provide better care to our patients while reducing the production cost per device. With national metrics, we would also be able to make better arguments for better reimbursement from all payers. Having metrics allows us to break down our data into segments, further allowing us to determine where the greatest slowdowns and inefficiencies in our processes are, improving patient care.


Nathanael Feehan, LPO, is the CEO and a practitioner at Master's Orthotics & Prosthetics, Silverdale, Wash­ington. He can be contacted at