Describe the process of adjudication.
A) the process of appealing a rejected claim
B) the practice's monitoring of the money that is needed to run the practice
C) the practice's comparison of each payment sent with a claim
D) the payer's process of putting a claim through a series of steps designed to judge whether it should be paid

Question

Quizplus · Accepted Answer

Adjudication in the context of healthcare insurance refers to the payer's process of evaluating a submitted claim to determine its validity and decide on the extent of payment. This involves a series of steps including verification of coverage, checking for necessary documentation, and ensuring the claim complies with the terms of the policy.

Describe the Process of Adjudication