Other large payers have invested in real-time platforms. Blue Cross Blue Shield of North Carolina provides immediate adjudication through health IT vendor RealMed.

Morgan Tackett, director of electronic solutions, said BCBSNC has seen an increase in e-claims from 63 percent in 1999 to 92 percent in 2007. Suspends, denials and telephonic inquiries have decreased, while throughput has increased.

BCBSNC is looking to drive e-submission rates to 95 percent and provide institutional batch claims and true end-to-end with electronic funds transfers and allow attachments and secure communication.

Payers need to engage associations and organizations to promote real-time claims adjudication to their membership, Willman said.