OPD Adjudicator

Claims Adjudication Dashboard

Review claim volume, decision quality, financial exposure, and automated rule outcomes from one clean operational view.

Core Operations

Evaluation Metrics

Claim Adjudication Pipeline

A simple view of how each claim moves from submission to decision.

01

Upload Files

Prescription and bills are submitted

02

Extract Data

Medical and billing fields are structured

03

Apply Rules

Policy limits and exclusions are checked

04

Record Decision

The claim is approved, rejected, or queued