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Ensure that contracts cover real-time claims adjudication

Many payers are jumping on the bandwagon to develop real-time claims adjudication (RTCA), which gives providers the information they need to collect the patient’s portion of their financial responsibility at the point of care. That’s a boon for providers, especially when patients are enrolled in high-deductible health plans (HDHP). The problem is that most managed care contracts don’t even mention RTCA, which could prevent provider organizations from enforcing its use.
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