Claim adjudication

In healthcare, claim adjudication is the process by which a health insurance company reviews a medical claim and determines if it should be paid, denied, or adjusted. This critical step ensures accuracy and compliance with policy terms. Nym’s autonomous medical coding solution supports the claim adjudication process by providing fully traceable audit trail for every code assigned by the engine.

Related terms

PEER INSIGHTS PLAYBOOK

The People Side of Autonomous Coding

Inside the Transition at Intermountain Health and OSU Physicians: What HIM and Coding Leaders Learned After Go-Live

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