What must be true for a claim to be considered a Clean Claim?

For a claim to be considered a Clean Claim, it must pass all front-end edits without deficiencies. This means that the claim has been checked for accuracy and completeness before being submitted for processing. A Clean Claim is one that can be processed without the need for additional information or correction, ensuring smoother and faster reimbursement. This is vital in the healthcare or insurance industry because it helps eliminate delays in payment and reduces administrative costs associated with correcting claims.

Options suggesting the need for a signature from the insured, submission electronically, or manual processing do not pertain to the criteria for a Clean Claim. While electronic submission can streamline the process, it is not a requirement for a claim to be considered clean. Similarly, whether a claim is processed manually or electronically does not affect its status as a Clean Claim; the decisive factor is the completeness and accuracy of the information provided.