Question:

When a patient presents an insurance card, the information is entered into the computer, and a claim is sent to the insurance company for payment or rejection. The process of the insurance company accepting or rejecting a claim is called `____`.

A adjudication

Explaination

The process by which claims are rejected or paid is called adjudication. This is part of the third party payor process.

When a patient presents an insurance card, the information is entered into the computer, and a claim is sent to the insurance company for payment or rejection. The process of the insurance company accepting or rejecting a claim is called ____.