Maximizing Clean Claim Submission Rates
- Clean claims = faster cash
First-pass payments reduce rework, cut costs, and ease staff burden. Top practices reach 90–95% clean claim rates. - Denials are rising
Errors from eligibility, prior auths, coding, documentation, data entry, and tech gaps drive most rejections. - Fix the biggest leaks first
Verify insurance early, capture accurate data, standardize coding, strengthen documentation, and scrub claims before submission. - Technology is key
AI and automation now predict denials, verify eligibility, and push leaders toward ≥95% clean claims. - Track what matters
Monitor clean claim rate, top denial reasons, days in A/R, and cost to collect—weekly. - Small fixes, fast ROI
Solving one issue like eligibility errors can boost clean claims 3–5% and speed cash flow.