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Dr. Eric Bricker discusses health insurance claims adjudication in today's tutorial. He emphasizes that understanding this process is crucial for everyone involved in healthcare and insurance. A claim starts with a submission by a provider (e.g., doctor or hospital) and is then processed by an insurance company for payment. The adjudication process occurs between submission and payment. Notably, "auto adjudication" is when claims are processed without human intervention, with about 85% of claims handled this way by software. In contrast, claims that require human handling cost approximately twenty dollars to process, underscoring the efficiency of automated systems in managing healthcare claims.
