Patent ID: 8494876

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 medical claims each medical 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; setting an initial score for each of at least some of the medical claims; adjusting at least some of the initial scores in a direction by evaluation at least some of the components of the medical claim request against at least some of the requirements for at least some of the medical claims and determining whether a component of the medical claim request matches a requirement; selecting a selected medical claim from the scored medical claims based on the adjusted scores; 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 adjusted score of the selected medical claim; 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.