Dental insurance claim processing can feel a little like a laboratory, where you are testing and tinkering to concoct the perfect combination to get them approved right away. Over time the biggest reasons why they are rejected become apparent, but there are many other ways your office can get paid faster. One of those is understanding the difference between real-time and batched claims.
To put it simply, real-time claims are exactly what they sound like. They are sent directly to the insurance payer, while batch claims go through a clearinghouse first. It’s rather difficult to know exactly which claims are “real-time” and which are batch even if you are sending them as each patient checks out. However, result is radically different for your office. The way you can have more real-time claims is by sending them through a system that has a lot of real-time insurance payer connections.
What’s the difference?
The biggest benefit to real-time claims is it goes straight to the insurance payer. (Note: not all insurance payers work in real-time, however many of the largest ones do). Behind the scenes what happens is a receipt is sent to the clearinghouse immediately, which is the transaction company and the way your office is paid. When you send claims in real-time your office usually gets paid within 24 hours.
In contrast, insurance payers usually take at least 48 hours to even receive the file for batch claims. Insurance payers use a mix of automated and manual processes to collect and validate batch claims. Batch payers also send out their payments in bulk, which slows down how quickly your office will see a check.
If a claim is rejected you know immediately with a real-time claim and can correct it for a resend. With batch payers, it might be a week before you know if the claim is actually accepted or denied. Real-time claims with attachments are also direct. Attachments through batch payers can add even more time to the processing journey.
What happens with ERAs?
When your office sends claims in real-time you will receive an ERA (Electronic Remittance Advice) telling you exactly how much you will get paid before the check comes. With batch claims, typically this doesn’t happen until after the check arrives; causing you to go back through the books after the fact and possibly have another round of phone tag with the insurance payer. When it comes to keeping your own books, real-time claims save you precious time.
What Renaissance does with real-time claims
Renaissance is the parent company who created Remote Lite powered by rPractice and owns Tesia clearinghouse. Meaning, Renaissance is an industry leader in EDI software development and in real-time claims through the connections that Tesia holds. Currently, Renaissance has more real-time connections than anyone else in the dental industry.
In Remote Lite powered by rPractice, your individual claims can be sent in real-time with the press of a button. Where it really comes in handy is not just that you get paid faster, but Renaissance’s support team can solve your claim issues even quicker with real-time claims. With real-time claims, our customer service dental superheroes can see the same claim numbers that insurance payers do, which makes it easy to track and diagnose. It also allows us to work with your office to resubmit the claim right away. Finally, if insurance payers are experiencing technical issues we will proactively inform you right away; always keeping you a step ahead.