#clean claims

[alexpetermbc]

Why are clean claims still getting denied?

90% of denials are preventable, yet they cost $25-$117 per claim to rework. Hidden reasons: credentialing lapses, eligibility gaps, medical necessity misalignment, timely filing violations (90-365 days depending on payer), prior authorization oversights, and payer-specific coding requirements.

The real cost: cash flow disruption, staff burnout (20-30% time on denials), patient dissatisfaction, and compliance risks. Solutions: real-time eligibility verification, payer-specific claim scrubbing, authorization tracking, credentialing audits, and continuous education. Practices implementing these strategies reduce denials 25-30%.

Stop losing revenue!

Read more: https://bit.ly/3XiF7Dk

Contact: 888-357-3226 / [email protected]

[imedicalbilling]

A Guide To Clean Claim Ratio

Clean claims are error-free submissions, free from issues or incomplete documentation that can lead to claim rejections or denials. The first component of a clean claim is ensuring that all claim information is accurate and correct. The second component involves ensuring the claim contains all the necessary information without omissions. US hospitals achieve average clean claim rates ranging from 85% to 95%. Managing and tracking claims can be challenging, but it plays a vital role in the healthcare revenue cycle and account receivable management.