Posts tagged Real Time Claims Adjudication
Real Time Claims Adjudication
Oct 13th
Healthcare providers using MTBC’s services can further accelerate their collections through real-time claims adjudication (RTA). MTBC already offers RTA with many of the major insurance payers, including United Healthcare, Humana, BCBS-FL, BCBS-PA, and BCBS-WV, and is in the process of testing its RTA with a number of other national regional payers.
RTA allows providers and their staff members to instantly calculate the patient’s responsibility and receive submission errors or rejections in real time, while the patient encounter is taking place. This service dramatically decreases the timeline for processing and reimbursement of claims, as RTA claims are submitted instantly and given priority by the insurer.
The significant benefits provided by RTA include:
- Ability to calculate the patient’s responsibility at the time of service;
- Ability to learn about errors in the claims in real-time as opposed to receiving rejection responses days later;
- Shortened timeline from claims submission to payment due to the fact that RTA claims are processed instantly and given priority in adjudication by the insurance payer.
For more information and scheduling a demo, please click here.
UnitedHealth Continuity–Insurance for your Insurance
Dec 2nd
UnitedHealth Group is again at the leading edge of technology and the delivery of healthcare services to patients and providers. Today UHC announced a new product designed to help patients secure medical insurance in the event they are no longer covered by another carrier.
In a way, UHC is offering insurance for your existing insurance. This first of its kind product is called UnitedHealth Continuity. It allows patients the right to purchase an individual insurance policy at some point in the future–even if the patient gets sick.
Patients who enroll in it will pay “20 percent each month of the current premium on the individual policy to reserve the right to be insured under the plan at some point in the future” (NYT). A typical Continuity plan is expected to average approximately $32 per month.
If the promised reforms of the incoming Obama administration materialize this service may become obsolete and in fact may become a free offering by all major insurance carriers. However, until that time, and with the job market collapsing, there are many people who may consider this a very welcome product. Additionally, if the Obama administration is unable to deliver on campaign promises to reform the purchase and delivery of healthcare insurance in the US, more insurance carriers maybe following in the footsteps of UHC.
UHC has been at the forefront of service delivery in the insurance space. It was among the first carriers to provide real-time claims adjudication–a service whereby physicians and their staff are able to immediately determine the patient responsibility on new claims.
Currently, MTBC is one of the only companies in the country providing this service for physicians who participate with UnitedHealth. Read more about MTBC and UnitedHealth here.
Real-time Claims Adjudication
Sep 22nd
Real-time claims adjudication: the process by which medical billing claims are submitted to a payer for processing whereby the claims are adjudicated automatically and payment/denial information is sent back to the submitter in real-time. The process allows the medical practice to submit a patient’s claim to the payer and determine the patient responsibility while the patient is still in the office.
MTBC, the Unique Healthcare IT Company®, has recently announced that it is offering automated real-time claims adjudication. RTA allows a practice to immediately determine the actual payment of the claim–eliminating lengthy delays between submission and payment.
RTA allows a practice to bypass the standard billing process by submitting claims directly to the insurance company’s claim adjudication systems. Administrative staff within the doctor’s office are able to use the RTA system to enter the procedure and diagnosis codes used by the healthcare provider as well as the patient co-payment and immediately receive notification of the claim payment.
The typical in-office billing process requires 20-60 days for claim adjudication.
This hallmarks of the typical medical billing process are: cumbersome software, exceedingly slow processing times, excessive data entry, and delayed payments. Real-time claims adjudication with MTBC eliminates these headaches by allowing a provider to immediately determine the patient responsibility.
MTBC’s RTA process provides claim responses in 3-7 seconds.
MTBC’s Real-Time Claims Adjudication Process with UnitedHealthcare
Currently this service is only available with UnitedHealthcare, however MTBC is in testing with Humana and Blue Cross Blue Shield of Florida. As more insurance companies come online with this technology, MTBC’s medical billing service will allow its clients to submit claims directly from its EMR software or from its web-based billing platform.
As other companies begin testing this technology and deploying it through EMR and PM software, physicians and their staff will reap the benefits of peace-of-mind and increased cash flow. At this time, MTBC appears to be the only company in the industry offering this service to its premium billing clients without any additional fees or expenses.
Key RTA Facts:
- Immediately send claim information and receive detailed payment information and patient responsibility
- Excellent tool for doctors who treat patients with high responsibility plans, deductibles, coinsurance, and co-pays
- Reduces patient accounts receivable
- Eliminates patient billing and patient telephone calls regarding bills submitted through RTA
- Reduce claim payment time