While you’re putting your clothes back on in the doctor’s exam room…a claim is generated and submitted electronically before you finish tying your shoes. By the time you reach the checkout desk, your doctor has received a payment commitment from your insurance company, just as Visa and MasterCard provide to a merchant after a customer swipes a card.
It’s called “real-time claims adjudication.”
If that’s the case, it seems that it should be a great deal easier to find out my costs ahead of time or at least, at checkout. Sometimes the office staff can tell me what I owe but mostly I’m told they’ll let me know after they hear from my insurance providers. I do like having an HSA but finding price information is a real struggle.
Sounds like a great idea. Let’s do it.
I agree with Tom and Catherine. This would be a huge improvement over what we have now.
The difference between what’s discussed above and actually buying groceries:
– No one has to take their clothes off at the grocery store.
– You can check the price of a box of cereal BEFORE you decide to buy it. In fact, you can go to several stores to check cereal prices.
If only it were that easy! Usually submitting claims means going through a list of extensive coding for procedures, double checking it and then finally going through a claims submission process. Then, we wait far too long before they finally pay (or deny) a claim, often for less that the usual cost. Too bad that we cannot just scan a barcode like they do at the grocery store!
There is something called float which is why a lot of west coast companies use obscure east coast banks. You couple float with the 20 day(?) maximum that an insurer can sit on your claim and you pretty much have the source of most insurance profits.
As for knowing the price of something ahead of time, just go to any vet and they will give you an estimate of treatment cost along with several options.