Question

2. Discuss the differences between "batch" and "online" adjudication, and the advantages or disadvantages of each.

Answer 1

The real-time adjudication (RTA) of healthcare claims is growing as more payers offer high deductible health plans that involve increase patient responsibility for the payment of healthcare services. RTA represents a sea change for not just payers, but providers and the healthcare consumer. This white paper concludes that the industry is not prepared, technologically or from a process perspective for this change and offers a number of recommendations to close the gap.

Real-Time Adjudication (RTA) of claims is a relatively new concept in the healthcare industry. RTA refers to the immediate and complete adjudication of a healthcare claim upon receipt by the payer from a provider. Unlike the current method of submitting and processing claims in batches over a period of weeks to months, RTA, as it implies, anticipates that the complete process from billing to patient payment occurs during the patient visit to the healthcare provider's office or other facility.

Online Processing: An online system handles transactions when the occur and provides output directly to users. Because it is interactive, online processing avoids delays and allows a constant dialog between the user and the system. The system processes transactions completely when and where they occur. Users interact directly with the information system. Users can accesss data randomly. The information system must be available whenever necessary to support business functions.

Batch Processing: Data is processed in groups or batches. Batch processing is typically used for large amounts of data that must be processed on a routine schedule, such as paychecks or credit card transactions. A batch processing system has several main characteristics: collect, group, and process transactions periodically. Batch programs require no user involvement and requires significantly fewer network resources than online systems.

Online processing is very effective these days. If we compare with batch processing system than online systems are expensive. Batch processing work in batches and then jobs is divided into sub jobs and then processed so it don’t need lot of hardware resources. As online processing involve mobiles data also so it is expensive. In decent development now our mobiles and small devices also do some type of batch processing. Now with the passage of time latest computer devices do work of both batch processing and online processing at a time.

Online processing is just like live processing in that case if user input some data by filling input form on any site then it get processed and data fetch from the database online at the same time. The online processing involves database servers, files on hosting and browser to communicate effectively and do fast work to be responsive. As the name suggests it is online so that mean it is live to action. The processing just on time.

In batch systems the data enter at any time may get processed days later. For example data collected about salaries and other transactions about customers get processed later at the date when reports are generated. Similarly inventories and salary distributed is processed later. So this batch processing is schedule based in which processing get time schedule of when to process data.