Clean Claim
- A clean claim is a claim that is submitted to insurance without an error or rejection and paid by insurance on the first submission.
- A clean claim will result in faster payment to the provider.
- A clean claim submission ratio must be 95%.
- To submit a clean claim, it is necessary to have knowledge of coding, knowledge of payers and their policies, verification of patient demographic and insurance on a regular basis, denial management, etc.
what is formula of calculating clean claim rate of any practice?
ReplyDeleteClean Claim = (Total Paid & Closed claims / Total Billed Claims) * 100
DeleteIts not total paid claims as this will give you paid claim %. It should be total clean claims, meanings went to the payer without any rejections divided by total billed claims
ReplyDeleteYes, you’re correct. Thank you for pointing it out. We’ve made the necessary correction.
DeleteWhat is the IDS process
ReplyDelete