When the topic turns to real-time claims adjudication, Bryan Braswell gets to the point-as fast as the technology itself. He's not interested.
Braswell is director of business services at OrthoCarolina, a large physician group based in Charlotte, N.C. With 180 physicians, 100 physical therapists, and some 80 other care extenders, OrthoCarolina sends the lion's share of its claims to less than 10 payers. The idea of processing a claim instantly-so the practice would know expected reimbursement and its patients would know their obligations before heading home, all within seconds of submission-would seem to be appealing. After all, real-time adjudication is designed to streamline both the revenue cycle for the provider and turn the health care encounter into a more customer-friendly transaction for the patient, one similar to common retail transactions where the cost of goods and services is known immediately, not the health care norm of days or weeks later. But Braswell's not buying. "If it led to real-time payment, we might consider it," he says. "But I don't see the value unless you are getting the money back at the same time."
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