How it works
Divide the number of claims accepted on first submission by the number of claims submitted in the same period. Some organizations count only claims accepted for processing; others count only claims paid without any correction. Both are useful, but they are not the same number, so say which one you use.
Why it matters
Every claim that has to be fixed and resent adds work and delay. A low clean claim rate points to problems with registration data, coding or claim setup that can be fixed before submission — usually through better claim scrubbing and front-desk checks.
Example
A practice finds many first-pass rejections for an invalid subscriber ID. The fix is not faster rework but checking the insurance card and running eligibility at check-in. See reducing claim denials.