What is a clean claim?

A clean claim refers to a properly completed billing form that meets all the necessary criteria and requirements of the payer. This includes having accurate and complete information, such as patient details, provider information, diagnosis codes, and procedure codes. When a claim is considered clean, it indicates that it is ready for processing without the need for any additional information or corrections, which helps streamline the reimbursement process.

When claims are clean, they are usually processed more quickly, reducing the chances of delays in payment. This is essential for healthcare providers, as timely reimbursement is crucial for maintaining their financial health. A clean claim also reflects the provider's adherence to billing protocols and accuracy in submitting claims, further minimizing the risk of denials and rejections.