First-pass resolution rate is the percentage of insurance claims that are paid correctly on initial submission without requiring appeal, resubmission, or additional documentation.

This metric goes beyond clean claim rate by measuring not just whether a claim was accepted, but whether it was paid correctly the first time. A claim might be "clean" but paid at the wrong rate or denied for medical necessity—that's a first-pass failure.

For telehealth, first-pass resolution rates typically run 5-10 percentage points lower than in-person claims due to payer processing complexity around telehealth services. Target 85%+ first-pass resolution; below 75% means your revenue cycle team is spending most of their time on rework rather than proactive improvements.

Track this by payer to identify which relationships need attention. Some payers process telehealth claims smoothly; others systematically underpay or reject claims requiring appeals. That intelligence should inform both your contracting strategy and your billing workflow design.

Related terms: Clean claim rate, Claims denial rate, Net collection rate