Manual Batch Adjudication

Perform adjudication for claims where changes have been made. Claims in the batch are edited in the following forms:

Provider Fee Definition
When the service fee is changed.

Service Authorization
When the service authorization is changed.

Plan Definition
When the service availability or disbursement amount is changed.

Set Associated Codes
Adding or deleting diagnoses, CPT, or revenue codes when these codes change the service availability.

Contracting Provider Registration
A back dated provider registration that changes the service availability by validating a service authorization.

Prerequisites:

• Claims must be in open batches.

1. ---

   Go to: Avatar MSO > System Maintenance > Manual Batch Adjudication
2. In the Select Batches field, select the batches.
3. Click Process.

► SQL Tables

• SYSTEM.batch_claim_lvl_core
• SYSTEM.batch_clm_svc_detail
• SYSTEM.batch_current_data