Adjudicate definition

Adjudicate means to determine whether all program requirements have been met and whether the claim is payable.
Adjudicate means an insurer pays, contests, or denies a clean claim;
Adjudicate means an insurer's decision to deny or pay a claim, in

Examples of Adjudicate in a sentence

  • Trautman, Jurisdiction to Adjudicate: A Suggested Analysis, 79 HARV.

  • Adjudicate undergraduate student petitions for academic reinstatement to the University.

  • Adjudicate student petitions regarding initial undergraduate admissions.

  • Adjudicate student petitions regarding such academic regulations as credit loads, transfer credit, and graduation requirements for all undergraduate degree programs.

  • Adjudicate third-party insurance claims using established billing systems.

More Definitions of Adjudicate

Adjudicate means to deny or pay a clean claim.
Adjudicate means to pay or reject a claim. A "clean claim" is a claim that can be processed without obtaining additional information from the provider of the service or from a third party. It includes a claim with errors originating in the Contractor’s claims processing computer system, and those originating from human errors. It does not include a claim under review for medical necessity, or a claim that is from a provider who is under investigation by a governmental agency or the Contractor for fraud or abuse. However, if under investigation by the Contractor, the Department must have prior notification of the investigation.
Adjudicate means the same as that term is defined by the District of Columbia Administrative Procedure Act, as codified at D.C. Official Code § 5-502.
Adjudicate means to make a finding of whether a child committed a delinquent act.
Adjudicate means to deny or pay a claim for services or drugs prescribed to a member by a health care provider.