Patent ID: 8099302

Claim:
A method of adjudicating a medical claim, the method comprising: providing a medical claim processing server accessible over the Internet by a medical service provider, the server having access to a database storing a plurality of claims each claim representing medical benefits and having a set of requirements; the medical claim processing server: receiving over the Internet a medical claim request from the medical service provider, the request comprising components including a proposed medical procedure that is to be performed on a patient; evaluating the components of the medical claim request against sets of requirements of at least some of the claims by setting scores to each of the at least some of the claims based on adjusting the scores according to how the components match with requirements within the sets of requirement; identifying a manner in which the scores were adjusted; selecting a selected claim from the scored claims based on the set scores and the manner the scores were adjusted; adjudicating the medical claim request by determining acceptance or rejection of the medical claim request and a monetary value of the proposed medical procedure according the score of the selected claim and the manner the selected claim's score was adjusted; transmitting a notification over the Internet to the medical service provider, the notification comprising one of (a) a rejection of the proposed medical procedure, and (b) an acceptance the proposed medical procedure with the monetary value; and presenting the notification via a user interface to a user associated with the medical service provider.