FRICTIONLESS PROCESSING FOR AUTOMATIC ADJUDICATION OF MEDICAL ENCOUNTERS

摘要

Systems and methods for providing automatic adjudication (auto-adjudication) of medical encounters are provided. For example, specific encounters corresponding to a billable service provided to a patient may bypass insurance verification billing, code validation, and/or claim scrubbing. The billable service may have a program bundle that can be utilized to determine if the encounter is eligible for a fast pass token. The fast pass token prevents insurance verification billing, code validation, and claim scrubbing for the encounter. Additionally, the program bundle can be utilized to determine whether the encounter is eligible to participate in auto-adjudication and electronic funds transfer, enabling real-time financial transactions for the encounter.