Real time claims adjudication (RTCA) is a software interface between a physician's practice management information system and a payers claims processing system that allows the practice to submit a claim at the time of checkout, and receive a response from the insurance company while the patient is waiting. It allows the practice to collect deductible and patient due amounts right there, on the date of service, before the patient leaves the office. The payer then sends the payment from them to the physician practice electronically.
Check with your software program, your cleariinghouse and your payers to see if it is available to you. There are other third party software vendors who are doing the processing. RTCA is in its infancy right now. A quick google search on the topic tells us how popular and timely the idea has become. Of course, it only works for you if your practice management system can interface with an insurance company that has the capacity to do it.
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options.
In 2020, Medicare will begin using a new Patient-Driven Groupings Model (PDGM) for calculating Medicare payment for home health care services. This is probably the biggest change to affect home health care since 2000.
How does the VA determine charges billed to third party payers for Veterans with private health insurance?
According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...
It is agreed that TMJ disorders should be covered by insurance. There are often questions whether it is covered by medical insurance or dental insurance and where the line is that separates coverage.Medical Insurance typically is the primary insurance for TMJ disorders. The reason is that joints are found anywhere ...