Get Ready to Take the Wheel

EFT Mandates: What You Need to Know When You’re In Control

We may only be in the early months of 2013, but it’s not too soon to set your sights on January 1, 2014. That’s the day you take the wheel, driving the decision on how you receive payments from payers: electronically or by check. By the appointed date, payers must be in compliance with the Department of Health and Human Services’ (HHS) standardized guidelines for Electronic Funds Transfer (EFT) enrollment and transmitting transactions, as part of the Patient Protection and Affordable Care Act (PPACA).

As part of the coming standards, payers will not only have to pay by EFT if requested by providers, but they must also offer electronic EFT enrollment. They must also comply by using Corporate Credit or Deposit Entry (CCD) with Addenda Record (CCD+Addenda) as the standard data transmission format to originate an EFT for healthcare payments through the Automated Clearing House (ACH) network. Importantly for you, the Addenda Record must include a Trace Reassociation Number (TRN), so you can match Electronic Remittance Advice (ERA) and EFT files together. These measures will help you reconcile these payments within your accounting systems.

The intention behind these new standards is to simplify the healthcare system by improving efficiencies for providers, payers and patients. Undoubtedly, you stand to benefit from the ability to demand payments by EFT via the ACH network. Direct deposits hold many advantages for you because they:
• Improve cash flow since electronic payments are virtually immediate eliminating the time you spend today waiting for checks to clear
• Minimize opportunity for error since the TRN will help link the ERA with the corresponding EFT payment
• Reduce workload by eliminating the labor involved with paper check processing

That’s all good news for organizations like yours that are constantly striving to improve collections.

Payers must comply by 1/1/14. The question is…will you be ready to be in the driver’s seat to demand payments electronically? While payers have more to contend with this in preparation for this deadline, your To Do list is relatively short. Nonetheless, you’ll be well served to be ready when 2014 comes around.

1. Make the decision now to go with EFT from your payers.
In determining your preference now, you have more time to anticipate the positive changes and benefits to come. Decide what account or accounts you will use for direct deposits so that you are ready when the time comes.

2. Express your preference for EFT to your payers now.
In communicating your request to receive direct deposits now, you will incent payers to move forward efficiently in adopting necessary changes. There may be some payers who achieve compliance in advance of the deadline, empowering you with EFT sooner than January of next year.

3. Enroll for and accept ACH payments.
If your organization is not already enrolled for ACH payments, take care of that immediately. Payers will be able to identify providers already enrolled and this will put you ahead of the curve by deadline.

4. Review workflows in preparation for elimination of paper check processing.
Once you are able to receive all payer payments by EFT, your staff’s time and energies can be diverted to other tasks. In addition to not processing paper checks, your team will benefit from the efficiency of the TRN that matches ERA and EFT. Review and plan ahead for how electronic payments will alter and improve your workflows and staffing.

5. Enroll with Emdeon ePayment
If you’re ready to start receiving payments electronically sooner than 2014, Emdeon ePayment can help you do just that. Since enrolling directly with each and every payer to get paid electronically can be a paperwork nightmare, Emdeon makes it easy. Just enroll ONCE, and get awesomely fast payments from the 88 Emdeon ePayment participating payers and automatically enjoy additional payers as we continually add more. Instead of receiving checks in the mail, you can get payments from participating payers directly deposited into your organization’s bank account. Visit us online to complete your enrollment today. Or give us a ring at 866.506.2830 with any questions you might have.

Article References:


CMS Rule Seeks to Streamline EFT and Remittance

Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds Transfers (EFT) and Remittance Advice Transactions
(H. Applicability. 1. Covered Entities: Health Plans, Health Care Clearinghouses, and Health Care Providers)

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