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hello this is dr eric bricker and thank you for watching a health care z todays topic is health insurance claims adjudication now weve covered many boring topics here on a health care c and this is among the most boring as well so please stick with me i promise itll be worth it everybody that works in healthcare employee benefits and health insurance has to understand claims adjudication now a claim is originally submitted by a provider doctor hospital etc and then it gets paid by the insurance company back out to them now the process in between the claim submission and the claim being paid is referred to as adjudication what were going to talk about now auto adjudication is where no human being touches the claim between submission and payment and like 85 of claims are auto adjudicated so the vast majority of stuff is handled by software not by people now if a person does handle the claim it costs about twenty dollars to process that claim so given the hundreds of millions or bill
