Increase your percentage of ‘clean’ claims and improve your bottom line!
How many of your claims need to be reworked because of rejections due to errors on the claim, or denials due to missing information, coding errors, or incorrect patient coverage? Could these be avoided? The ideal clean claim submission rate is >95% – the most profitable claim is one that is paid correctly, first time.
What is a ‘clean’ claim?
A clean claim is one that can be processed by the payer without having to request any additional information. This means that the claim has been ‘scrubbed’ to ensure accuracy before submitting – patient, provider, and clinical information has been verified, and codes/charges checked.
How does this impact your bottom line?
Clean claims are processed and reimbursed more quickly by payers, which reduces A/R turnaround times and improves cash flow. They also require less handling by employees, which lowers the cost per claim and allows staff to spend more time on core business functions.
How to increase your clean claim submission rate
In our fact sheet 6 ways to avoid claim rejections and denials, we outline common issues that cause rejections by billing software if not picked up by your billing staff, before a claim even reaches the clearinghouse or payer. Although this doesn’t increase your denial rate, these rejections still cause additional work for your team, impact your overall performance, increase the cost of processing each claim, and extend A/R timeframes. The good news is that this can be avoided!
Do you know your clean submission rate? If it’s <95%, now would be a good time to review your processes and identify any training requirements.
