Practice Management Alert

For professional (CMS-1500) 837P claims, real-time claims adjudication (RTCA) consists of two major components, says Daniel Kazzaz, chair of Accredited Standards Committee (ASC) X12 and president of Rapid Data Interchange in Bethesda, Md.

First: When you enter a claim, you-re immediately informed of errors and can clean up the claim on the spot.

Second: "The second part is the adjudication, which computes the amount to be paid by the patient and by the payer," Kazzaz says This allows you to collect the patient responsibility amount at the time of service.

Hospital difference: Hospitals can also benefit from the real-time error correction and can "take advantage of RTCA to help the patient figure out a payment plan sooner rather than later," Kazzaz says.