First-Pass Payment is Our Goal
Every day a claim sits in rejected or denied status is a day your practice isn't getting paid. HealthEdge Solutions utilizes a rigorous claim scrubbing process before a single claim is transmitted to the clearinghouse or payer — ensuring maximum first-pass approval rates.
Our commitment to clean claim submission means we consistently achieve first-pass resolution rates exceeding 95%, significantly reducing the time it takes for your practice to receive payment.
Our Claim Scrubbing Engine
- Verification of patient demographic and insurance data accuracy
- CCI (Correct Coding Initiative) edit checks for bundling compliance
- LCD/NCD medical necessity validation against payer policies
- Payer-specific rule applications and format compliance
- Real-time eligibility confirmation before submission
- Electronic transmission via direct EDI payer connections
Why Clean Claims Matter
💰 Faster Payments
Clean claims are paid in an average of 14–21 days versus 45–90 days for dirty claims.
📉 Lower Denial Rate
Our 95%+ first-pass rate means fewer rework hours and less administrative burden.
🔗 1,500+ Payer Connections
Direct EDI connections with all major commercial and government payers nationwide.
📊 Real-Time Status
Track every claim's status in real time with our transparent reporting dashboard.