Over the past 10 years, one of the top administrative priorities for the healthcare industry has been the development of real-time adjudication (RTA) for healthcare claims. By 2005, the RTA effort had attracted a great deal of attention and effort across the industry. However, five years later, the results delivered have been underwhelming for both providers and payers.
The Core Problems
Although RTA makes sense from a high-level standpoint, the healthcare transaction process has nuances, both from a technology and business perspective.