Humana, BCBSFL offer real-time claims adjudication

BlueCross BlueShield of Florida and Humana are kicking off an initiative designed to speed real-time claims adjudication. The two health plans are already partners in Availity, a claims processing gateway. With this initiative, they plan to expand the effort to other payers, claims clearinghouses and practice management groups, the groups said in their press release. Physician groups that participate in this phase of the RTCA rollout must use physician physician revenue, clinical cycle management and EMR platform Athenahealth. The plans already work with physicians using healthcare revenue cycle management platform ZirMed, which runs the practices for most of Humana's existing RTCA participants.

Expect to see more efforts of this kind as consumer-driven policies become more popular. Given their high deductibles, it will become more important than ever for providers to know just how much the insurer will pay--and how much they must collect on the spot from patients. More than ever, practices will need to consider RTCA compatibility when they're buying or upgrading practice management software.

To get more background on this effort:
- see the Humana/BCBSFL release
- learn more about ZirMed 
- run the Athenahealth demo

Suggested Articles

Premera Blue Cross will pay $6.9 million to HHS over a data breach six years ago that exposed 10 million people's health information.

United Airlines is working with health company Color and GoHealth Urgent Care to roll out the first COVID-19 testing program for air travelers.

The potential long-term impacts of COVID-19 on how Medicare Advantage's star ratings are calculated remain unclear, experts say.