FIRST-PASS
RESOLUTION RATE
Metric 1.
What It Is:The first-pass resolution rate (FPRR) is the share of a practice’s claims that getpaid by insurers on first submission
Calculation:Total Number of Claim Charges Paid / Total Number of Charges Submitted
Benchmark:FPRR should be 90% or above.
Why It Matters: FPRR is a reflection of the effectiveness of your revenue cycle managementprocesses – from pre-visit processes like verifying insurance eligibility, adding required authorizations and maintaining accurate patient demographics topost-visit tasks like coding and billing. Getting it right the first time is criticalto maximizing both efficiency and profitability.
