Real time claims adjudication (RTCA) is a software interface between a physician's practice management information system and a payers claims processing system that allows the practice to submit a claim at the time of checkout, and receive a response from the insurance company while the patient is waiting.  It allows the practice to collect deductible and patient due amounts right there, on the date of service, before the patient leaves the office.  The payer then sends the payment from them to the physician practice electronically.  

Check with your software program, your cleariinghouse and your payers to see if it is available to you.  There are other third party software vendors who are doing the processing.  RTCA is in its infancy right now. A quick google search on the topic tells us how popular and timely the idea has become.  Of course, it only works for you if your practice management system can interface with an insurance company that has the capacity to do it.