Real-time adjudication – a long-sought goal of physician practices – allows for the analysis of payments and rejections on the spot before a patient even leaves the office.

In an industry where consumer directed health plans and high deductible plans are becoming more popular, “we need to know what we have to collect from the patient,” said Tom Morrison, co-founder and executive vice president of product marketing at Cambridge, Mass.-based NaviMedix. “Our sense is that the providers care about two things: easy to use and knowing how much to collect from the patient.”

There’s not as much worry about when the check will come for payment, he said.

Morrison predicts that it will be 3-5 years before the industry fully catches on to the trend.

Real-time adjudication predicts what the patient’s responsibility is from benefit information. It’s a statistical approach, digging into benefit systems and contracts for some products.

Rocky Mountain Gastroenterology, a six-locations practice in Colorado that employs 23 physicians who perform more than 30,000 procedures a year, saw a one-time increase of $700,000 after implementing Navicure’s real time adjudication product, paired with Allscript’s practice management tool.

“All we can do is try to keep the process going as quickly as possible,” said Craig J. Bakken, the practice’s CEO.

The practice dropped the time spent communicating with insurance companies, start to finish, from 35-40 days to about 20.

“The faster we can get that under way the faster we can get the money from the patient,” said Bakken. “The longer it takes to collect, the harder it is to collect.”

“One of the problems in real-time adjudication is that not all practices are set up to have claims coded correctly before the patient checks out of the office,” said Craig Bridge, chief operating officer for Navicure. “A limited number of insurance companies even allow practices to use the tool. United Healthcare, Humana and a handful of Blue Cross Blue Shields are among the few.”

“Real time adjudication makes a big difference, it’s been a worthwhile investment,” said Bakken.