Claims Adjudication | Mirra Health Care

 Claims Adjudication decides whether a claim is payable, how much, and to whom based on eligibility, medical policy, coding, pricing, and coordination of benefits. Streamlining this process with rules-driven automation, pre-adjudication edits, and real-time validations reduces errors and denials. Integrated analytics highlight root causes, improving first-pass rates and speeding reimbursements. Audit trails and consistent application of rules strengthen compliance and simplify appeals. When aligned with eligibility and provider data, adjudication eliminates mismatches and accelerates resolution. For payers, TPAs, and providers, optimized claims adjudication means cleaner claims, faster payments, lower administrative costs, and stronger trust across the care ecosystem. 

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