Healthcare News & Insights

New rule simplifies electronic payments

Good news! An interim electronic funds transfer rule will make life easier for your facility by streamlining healthcare administrative transactions.

A provision in the Affordable Care Act (ACA) has set new standards with electronic funds transfers for carriers.

The changes are expected to save providers and health plans up to $4.6 billion dollars over the next decade, according to the U.S. Department of Health and Human Services (HHS). The estimates were included in a proposed rule that cuts red tape and simplifies administrative processes for doctors, hospitals and health insurance plans.

And the best part? You won’t have to do a thing.

The new rule – the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice – creates a universal standard format all carriers must use when transmitting data to banks for electronic payments.

Another major change: Carriers must now use a tracking number linking payments with remittance advice notices. This means staff will no longer have to hunt down this information to manually match up bills with payments.

Currently, when health plans bill providers, they’re identified using a number of different identifiers that don’t have a standard length or format. As a result, healthcare providers run into a number of time-consuming problems, such as misrouting of transactions, rejection of transactions due to insurance identification errors and difficulty determining patient eligibility.

But no more.

The regulation went into effect at the beginning of the year, and all health plans covered under HIPAA have until 2014 to fully comply.

In the not-too-distant future, HHS will issue additional simplification rules under ACA, including standards for claims attachments and requirements for certification of health plans’ compliance with all HIPAA standards and operating rules.

All of these administrative simplifications will require less time on the part of providers filling out forms and give them time to do what they were trained for – taking care of patients.

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