You’re at the grocery store. The cashier finishes ringing up the total. Instead of handing you a paper itemization memorializing the transaction, it is sent electronically into the nether world at the same time you insert your bank card into a machine linking the grocery store with someone else’s bank account. No copay needed. The bill is paid in full instantly. No balance billing. If the Food Stamp program can do this, why can’t your health plan?
Real-time payments (RTP) initiated and settled instantaneously at the point of service is the future of health care financing. And the future is now………………
Historically, RTP communication has flowed in one direction: from the payer to the payee. In a health care claim transaction settlement there must be an exchange of information back and forth between the provider of health care services and the payor of health care services. This is done outside the payments system.
Technology exists to connect real-time medical claim payments with supportive payment data together in a single transaction.
Our current system of claim adjudication takes a lot of manpower, overhead expenses, and time. Most if not all of that is eliminated through point of service claim adjudication.
Third party administrators would be wise to adapt to this growing trend. Some have already done so but most haven’t.
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