View the Clean Claims Report
The Clean Claim report displays the percentage of claims passing EDI edits that are in a status of accepted or acknowledged. It reflects the percentage of claims not requiring edits before submission.
A clean claim is a claim with no defect or impropriety, no lack of required substantiating documentation or no circumstance requiring special treatment that prevents timely payment. This report shows a count of all claims in a status of accepted and acknowledged (clean), compared to total claims and the percentage of clean claims. The bar graph color format indicates the following:
| Color Bar | Percentage |
|---|---|
| Red | Percentages between 0.00 - 92.99. |
| Yellow | Percentages between 93.00 - 96.99. |
| Green | Percentages between 97.00 - 100. |
- Select the eStatus tab.
- Select Claims from the Reports tab.
- Select Clean Claim Report.
The report displays with default search criteria data displaying the claims submitted, the total claim count, the number of claims accepted and acknowledged (clean claims), the clean claim percentage, and the average percentage of clean claims for the selected date range.
- Select Filter Options to enter specific search criteria.
- Select Filter to display results.
- Select the date in the Date Submitted column to view details via the Run Summary.
- Select Export to download grid results.