Clean claim rate is the percentage of medical claims submitted to a payer that are accepted and processed without errors, rejections, or requests for additional information on the first submission. It is one of the most widely used key performance indicators in revenue cycle management, and top-performing organizations target a clean claim rate of 95% or higher. Accurate medical coding is one of the primary drivers of first-pass acceptance. Nym’s autonomous medical coding engine can help increase clean claim rates by assigning accurate, compliant codes to patient encounters. In turn, this helps reduce coding errors, which are among the leading causes of claim rejection, and helps health systems achieve and sustain high clean claim rates.
