Concepedia

Claims Adjudication

Claims Adjudication is a formal decision-making process within claims management whereby an insurer evaluates a submitted claim according to policy terms, regulatory requirements, and medical necessity criteria to determine benefit eligibility, coverage responsibility, and payment accuracy.

32

Publications

955

Citations

58

Authors

34

Institutions

Publications per year

2017–2026

4

Variants

Claim AdjudicationInsurance Adjudication

Parents

Children

Publications

32

A better approach to medical malpractice claims? The University of Michigan experience.

Richard C. Boothman, Amy C. Blackwell, Darrell A. Campbell et al. · PubMed · 2009 · 134 citations

, , +14

Settled out of Court: The Social Process of Insurance Claims Adjustment

H. Wayne Snider, H. Laurence Ross · Journal of Risk & Insurance · 1971 · 67 citations

, , +13

The Small Claims Court: A Reconceptualization of Disputes and an Empirical Investigation

Neil Vidmar · Law & Society Review · 1984 · 51 citations · Full text

, , +10

Operators for the adjudication of conflicting claims

William Thomson, Chun‐Hsien Yeh · Journal of Economic Theory · 2008 · 50 citations

, , +6

A new solution to the problem of adjudicating conflicting claims

Diego Domínguez, William Thomson · Economic Theory · 2005 · 45 citations

, , +8

1–5 of 32

Authors

58

  1. WT
    William Thomson

    University of Rochester, United States

    8 publications · 264 citations

    8

    h-index

  2. JD
    Juan D. Moreno‐Ternero

    Universidad Pablo de Olavide, Spain

    2 publications · 79 citations

    2

    h-index

  3. DD
    Diego Domínguez

    Instituto Tecnológico Autónomo de México, Mexico

    2 publications · 61 citations

    2

    h-index

  4. HL
    H. Laurence Ross

    Saskatchewan Hospital, Canada

    2 publications · 92 citations

    2

    h-index

  5. FD
    Fred DuBow

    University of Illinois Chicago, United States

    1 publications · 40 citations

    1

    h-index

1–5 of 58

Institutions

34

  1. University of Rochester

    Rochester, United States

    9 h-index

    11 publications

    359 citations

  2. UCLouvain

    Louvain-la-Neuve, Belgium

    2 h-index

    2 publications

    79 citations

  3. Universidad Pablo de Olavide

    Seville, Spain

    2 h-index

    2 publications

    79 citations

  4. Istituti di Ricovero e Cura a Carattere Scientifico

    Rome, Italy

    1 h-index

    2 publications

    46 citations

  5. Instituto Tecnológico Autónomo de México

    Mexico City, Mexico

    1 h-index

    1 publications

    16 citations

  6. Instituto Valenciano de Investigaciones Económicas

    Valencia, Spain

    1 h-index

    1 publications

    37 citations

  7. William Carey University

    Hattiesburg, United States

    1 h-index

    1 publications

    31 citations

  8. University of Alicante

    Alicante, Spain

    1 h-index

    2 publications

    74 citations

1–8 of 34

Venues

  1. Economic Theory

    3 publications · 99 citations

    3

    h-index

  2. Social Choice and Welfare

    3 publications · 90 citations

    3

    h-index

  3. Games and Economic Behavior

    2 publications · 42 citations

    2

    h-index

  4. Journal of Risk & Insurance

    2 publications · 95 citations

    2

    h-index

  5. Law & Society Review

    2 publications · 76 citations

    2

    h-index

1–5