About Adjudication? The process of reviewing medical claims for necessary information before making payment initial process that is reviewing demographic information of patients procedure codes and diagnosis codes. Automatic review eligible date of service pre certification, authorisation, timely and late date of service. Manual review, necessary information need to verify manually, payment determination Fully paid, partially paid, Denial. Once verified payment submitted to the medical officer supplied by the insurance payer advice explanations of payment is nothing but explanations of Benefits, need to explain about Payments.