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Timely and accurate processing of claims to determine the validity of the claim and the amount to be paid.
Input
- Claim
- Beneficiary identifier
- Adjustments
- Voids
- Benefit plan
- Re-submitted claims
- Claims-related policies
- Pre- authorization match
- Eligibility status
- Benefit class
- Beneficiary accumulators
- Co-insurance
- Copayments
- Deductibles
- Fee schedule
- Provider identifier
- Provider accumulators
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