What is Real Time Adjudication (RTA)? Which claims are eligible for Real Time Adjudication?

Real-time adjudication (RTA) refers to the immediate processing of certain claims, helping members receive reimbursement more quickly. To support this faster payment process, we may ask additional questions during the claims process to validate claim details.

RTA may be available for a range of health, prescription drug, vision, and other covered benefit claims. Eligibility is determined based on the type of claim and other claim-specific processing criteria. Some claims may require additional review and cannot be processed in real time.

Claim submissions must include detailed receipts. Saskatchewan Blue Cross may also request treatment records, proof of service, or other supporting documentation.

To help protect our members and plan sponsors, all claims remain subject to verification, audit, and review before or after payment. Any claim submitted with inaccurate, misleading, or fraudulent information may be denied, adjusted, recovered, or referred for further investigation.