8.4 The Readjudication Process

Once the plan's design has been defined, the model is ready to be simulated. The simulation engine runs through employee by employee, claim by claim and readjudicates the individual charges based on the modified plan settings. During this process, a status screen displays current progress, the estimated time to completion, and the average number of employees processed per second:


While most models run to completion in one to five minutes, it is not necessary to wait for the adjudication process to complete. You may browse away from the model at any time — just remember to save the report so you can return when the model is complete.

The length of time required to simulate a model is based on a number of variables, including the amount of employees and claims to process, the length of the time period, and the complexity of the model itself. A large number of benefit level coverage maximums can slow the adjudication process down considerably.