Though some health insurers do offer the service and vendors do provide the technology, real-time claims adjudication remains a pipe dream in most circles, requiring tight integration of practice management systems and payer databases, as well as behavior changes among office staff and patients alike. Yet, with more patients now directly responsible for a growing share of their healthcare expenses, providers are losing untold millions by not collecting small payments at the time of service. A Minneapolis-based vendor called mPay Gateway is trying to alleviate this problem by applying processes common in many retail settings to healthcare. FierceHealthIT