ONLINE CLAIMS SUBMISSION AND ADJUDICATION SYSTEM

摘要

The present invention relates to online claim submission adjudication, verification and rating systems, including systems for determining the accuracy of online claim submissions and detecting errors in association with online claim submissions. The present invention is directed to methods to identify claims submitted online that may be targeted for further processing (e.g. real time or other manual auditing). An online adjudication process of the present invention allows a carrier or payor to determine whether auditing is recommended.