Is Your Physician Practice Measuring it’s First Pass Resolution Rate?

What It Is – The first-pass resolution rate (FPRR) is the share of a practice’s claims that get paid upon first submission.

Calculation – FPRR = Total Number of Claims Paid ÷ Total Number of Claims in a given time

Benchmark – Your practice should aim for a FPRR of 90% or above.

Why It Matters – FPRR is a reflection of the effectiveness of your revenue cycle management processes – from pre-visit processes like verifying insurance eligibility, adding required authorizations, and maintaining accurate patient demographics to post-visit tasks like coding and billing. Submitting claims right the first time is critical to maximizing both efficiency and profitability, so always aspire to have the highest FPRR possible.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.