RFP News
Published on Nov 06, 2009
Consumers Life of Georgia has developed and piloted its own Real-Time Claims Adjudication (RTCA) system to enable patients to instantly take care of financial obligations at the point and time of their medical care.
Introduced in October 2008, RTCA was piloted by four physician offices. Feedback from the physicians of varying specialties indicates that the system is easy to use and patients too find it easier to conduct business at the point of service.
"The results are encouraging," says Rich Waldron, Consumers Life vice president of Network Management. "As for expediency, the claims submitted are fully adjudicated and returned to the physician and member in seconds."
The web-based RTCA system was developed in-house by Consumers Life parent company Medical Mutual and mirrors the layout of a claim form. The system provides users with the status of a completed claim within seconds of submission. The resulting documentation is an Explanation of Benefits (EOB), which is printed and provided to the member for his/her records. *
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