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Validating a claim

Updated on May 20, 2022

Validate a claim to decide whether the claim can be auto adjudicated or sent for manual review.

Validation of the claim occurs at two points in the claims process.
Prevalidation
Occurs when rules are executed before the claim is submitted to the adjudication system.
Validation
Occurs during the claim adjudication, after the claim has been submitted to the manufacturer.

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