The New EFT Standard And Automatic Reassociation

A new healthcare electronic funds transfer (EFT) standard went into effect at the beginning of the year, yet many healthcare IT professionals are still unaware of it and the time and money savings it can provide.

In the past, the lack of an EFT standard placed a heavy burden on providers. Providers interested in receiving EFT payments had to deal with a variety of enrollment procedures, and transactions were often delayed. There was also no standard for reassociation of data—making it difficult to match payments with claims.

As part of the Patient Protection and Affordable Care Act, the new Healthcare EFT Standard took effect in January to help remedy those problems. Enrollment, security and reassociation processes have all been established, making it easier, safer and more efficient for healthcare providers to receive EFT payments via the c.

For healthcare professionals, including billers, coders and IT personnel, the new standard offers a faster, easier and less expensive way to handle payments. For example, each EFT payment includes a reassociation number, which makes matching outstanding claims with payments quick and easy for accounting offices. The Healthcare EFT Standard is the only payment method with this feature.

Healthcare EFTs via ACH are also faster than paper checks and card payments. Healthcare EFTs are received as quickly as direct deposit, and the transferred funds are available up to seven days faster than with paper checks.

Additionally, healthcare EFTs via ACH are more secure than checks—the dominant payment form targeted by fraudsters—and all transactions are compliant with HIPAA privacy standards.

The most significant benefit, though, might be the cost savings afforded by using healthcare EFTs instead of other payment types. The cost of a claims payment using the Healthcare EFT Standard is, on average, 34 cents. Other EFT payment types, such as wire transfers and credit cards, can cost $10.73 or more per transaction.

Those cost reductions, combined with additional savings on items like paper, could save physician practices and hospitals an estimated $3 billion to $4.5 billion over the next 10 years, according to preliminary estimates from the Department of Health and Human Services.

Healthcare practices can easily begin realizing the benefits of the new Healthcare EFT Standard. To get started, they simply have to contact their health plans, choose the Healthcare EFT Standard and provide the health plans with their payment information. All health plans must be able to deliver the EFT standard if requested by a provider. According to the Centers for Medicare & Medicaid Services, the agency responsible for enforcing the Healthcare EFT Standard, health plans are not allowed to delay or reject an EFT or ERA transaction and/or charge an excessive fee, or give providers incentives to use a payment method other than the ACH Network.

For more information on the new Healthcare EFT Standard, visit healthcare.nacha.org.

Priscilla Holland, AAP, is senior director of healthcare payments at NACHA – The Electronic Payments Association.