Adjudication
Adjudication
Adjudication
IMPORTANCE :-
Competitions
Adjudication can also be the process, at dance competitions, in television game shows and at
other competitive forums, by which competitors are evaluated and ranked and a winner is found.
In court
"The legal process of resolving a dispute. The formal giving or pronouncing of a judgment or
decree in a court proceeding; also the judgment or decision given. The entry of a decree by a
court in respect to the parties in a case. It implies a hearing by a court, after notice, of legal
evidence on the factual issue(s) involved. The equivalent of a determination. It indicates that the
claims of all the parties thereto have been considered and set at rest." [1]
In construction
The relevant legislation in the United Kingdom is the Housing Grants, Construction and
Regeneration Act 1996 (1996 Chapter 53).[2] [clarification needed]
In healthcare
"Claims adjudication" is a phrase used in the insurance industry to refer to the process of paying
claims submitted or denying them after comparing claims to the benefit or coverage
requirements. The adjudication process consists of receiving a claim from an insured person and
then utilizing software to process claims and make a decision or doing so manually. If it is done
automatically using software or a web-based subscription, the claim process is called autoadjudication. Automating claims often improve efficiency and reduce expenses required for
manual claims adjudication. Many claims are submitted on paper and are processed manually by
insurance workers.
After the claims adjudication process is complete, the insurance company often sends a letter to
the person filing the claim describing the outcome. The letter, which is sometimes referred to
as remittance advice, includes a statement as to whether the claim was denied or approved. If
the company denied the claim, it has to provide an explanation for the reason why under regional
laws. The company also often sends an explanation of benefits that includes detailed information
about how each service included in the claim was settled. Insurance companies will then send
out payments to the providers if the claims are approved or to the providers billing service.
The process of claims adjudication, in this context, is also called "medical billing advocacy".
Background investigations[edit]
Adjudication is the process directly following a background investigation where the investigation
results are reviewed to determine if a candidate should be awarded a security clearance, or be
suitable for a public trust position, which is a job that requires a very knowledgeable and
responsible person, often related to national security. It may be determined that the person is not
suitable for a public trust position, but is suitable for a non-sensitive position. However, a person
may be deemed unsuitable for any position.
From the United States Department of the Navy Central Adjudication Facility: "Adjudication is the
review and consideration of all available information to ensure an individual's loyalty, reliability,
and trustworthiness are such that entrusting an individual with national security information or
assigning an individual to sensitive duties is clearly in the best interest of national security."
Emergency response[edit]
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Adjudication is the process of identifying, with reasonable certainty, the type or nature of special
nuclear material or nuclear device that set off an alarm and assessing the potential threat that the
material or device might pose with corresponding implications for the need to take further action.
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