What is “dirty claim” in medical billing?

Dirty Claim in Medical Billing

A dirty claim is a claim submitted with errors, missing information, or incorrect codes that prevent it from being processed and paid by the insurance company.

Dirty Claim in Medical Billing Explained

In medical billing, dirty claims lead to delays in payment or outright denial by insurance companies. These claims must be corrected and resubmitted to ensure proper payment. Dirty claims can result from data entry errors, missing patient information, or incorrect coding.

For example, a claim submitted without the patient’s date of birth or with an incorrect CPT code would be considered a dirty claim.

Check acronyms and abbreviations in Medical billing glossary.

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