What is First-pass resolution rate?
The share of claims fully resolved on the first submission, with no rework, appeal, or resubmission.
Definition
First-pass resolution rate is the outcome-side companion to clean claim rate: not just whether the claim was accepted, but whether it was paid correctly without anyone touching it again. It is the closest single measure of how much manual labour your revenue cycle requires per dollar collected.
It also captures underpayments that other metrics miss. A claim paid below the contracted rate is not denied and did not reject, but it is not resolved either — and unless someone is comparing allowed amounts against contracts, it will be counted as a success.
Why it matters
Every point below 100% is a claim a human has to touch again. That labour is the largest controllable component of cost to collect.
Denial codes to know
Related terms
See this in your own numbers
PayerVista turns the remittance files your payers already send into a live view of claims, denials, payer performance, and outstanding AR — in minutes, with no implementation project.