Abstract: An automated medical and/or dental tool that preforms an analytic process within a system database to determine if the medical or dental service billed by a provider meets payer reimbursement requirements and medical necessity, thus eliminating EDI usage, transaction costs and utilization of a clearinghouse to conduct a primary claim/encounter analysis. This tool will also assist dental providers in determining if a medical HCPC or CPT can be billed to the medical payer in addition or in substitution to the billed dental service submitted to the dental payer.