Method and system for adjudicating claims in a health services environment

摘要

Methods and systems for adjudicating claims in health services environments are presented. An exemplary method for processing service provider claims for payment includes scheduling appointments with service providers, receiving claims from the service providers, determining whether at least one scheduled appointment corresponds with at least one received claim and determining that at least one scheduled appointment has not been identified as corresponding to at least one received claim within a predetermined period of time. Optionally, the method includes presenting the particular received claim for payment when at least one of the scheduled appointments corresponds to the particular received claim.