What stage follows adjudication in the life cycle of a claim?

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Multiple Choice

What stage follows adjudication in the life cycle of a claim?

Adjudication is the payer’s review and decision process that determines coverage and the amount payable, including patient financial responsibility. The step that follows is payment, when the payer issues the approved amount to the provider and sends a remittance explaining the calculation and any patient responsibility. Submitting happens earlier to get the claim into the system; follow-up comes if information is missing or a claim is denied, and adjustments are changes made after adjudication or payment.

Adjudication is the payer’s review and decision process that determines coverage and the amount payable, including patient financial responsibility. The step that follows is payment, when the payer issues the approved amount to the provider and sends a remittance explaining the calculation and any patient responsibility. Submitting happens earlier to get the claim into the system; follow-up comes if information is missing or a claim is denied, and adjustments are changes made after adjudication or payment.

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