First-pass resolution rate (FPRR) measures how many claims are paid without being corrected, resubmitted or appealed. It reflects the quality of the whole front end: registration, eligibility, authorization, coding and claim scrubbing.
Formula
First-pass resolution rate = claims paid on first submission ÷ total claims submitted × 100
Related terms
- Clean claim rate
- The share of claims that pass all edits and are accepted on the first submission.
- Denial rate
- The share of submitted claims that payers deny.
- Claim scrubbing
- Checking a claim for errors and payer rules before it is submitted.