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When a claim undergoes adjudication, it refers to the process where the insurance company reviews the claim to determine whether it is valid and what payment, if any, will be made to the healthcare provider. During this process, the claim can end up being paid, denied, or suspended based on the findings of the review. This comprehensive evaluation considers the details of the submitted claim, the patient’s coverage, medical necessity of the services rendered, and adherence to insurance policy terms.

The other responses primarily focus on specific outcomes or actions that are part of the adjudication process. While a claim can indeed be reviewed and not paid or modified and resubmitted, these are specific outcomes of the overall adjudication process rather than a full definition of what adjudication encompasses. Forwarding a claim for further investigation is also a possible step but is typically part of the adjudication process when additional information is needed to make a final determination. Thus, the essence of adjudication includes all the potential outcomes, reinforcing why the chosen answer accurately captures this multi-faceted process.