Navigation:  Claim Adjudication > Saving an Adjudication

To save an adjudication, click the Save Adjudication button on the lower right. This will write any adjustments into the claim adjustment tables. Claim lines that have not been adjudicated will have a status or a status and an adjustment added to them as specified in the default adjudication options. Adjudication information is only ever written to the database tables after clicking the Save Adjudication button.

 

 

The is now considered Adjudicated unless claim lines were pended. In that case, the claim is partially adjudicated.

Here is what happens when you click "Save Adjudication":

·The record in EDI_Claims/EDI_ClaimDetail will be amended with the claim status information that was assigned either automatically with default settings or manually by the adjudicator.

·The billing provider will be checked against the payee table. If the record does not exist it will be created on the fly.

·A record will be created in the ClaimAdjustmentHeader/Detail tables that stores all the adjustment information that was put together in the process. The claim adjustment table record is tied to the claim record via the ID field.