A small group of Florida internists is having luck with real-time claims adjudication. Nearly half the claims filed by Orlando (Fla.) Internal Medicine are adjudicated in real-time, with the practice receiving near-instantaneous transmissions from its payers about the money it will receive for a given claim and what the level of patient responsibility is.
Pradeep Vangala described the system in play at the HIMSS 2010 Conference, noting that nearly 45% of its patients are on Medicare, one of three payers that support real-time adjudication. The other two are Humana and the Florida Blues plan.
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