What are clean claims?

• A. Claims without errors that are submitted for reimbursement.
• B. Claims with missing information.
• C. Claims that are submitted without attachments.
• D. Claims that are never processed.

Answer: (A)

Clean claims are those that can be processed for payment without additional information or corrections. They contain all required data accurately—complete patient and provider identifiers, dates of service, valid diagnosis and procedure codes (CPT/HCPCS/ICD), units or quantities, and any necessary modifiers or attachments already included. Because they meet the payer’s initial edits, these claims are ready for adjudication and reimbursement. If information is missing, incorrect, or required documentation isn’t submitted, the claim isn’t clean and will typically be returned or denied until the issues are resolved.