An initiative to help providers easily enroll to receive electronic funds transfer and electronic remittance advice from insurers got off to a slow start but has gained momentum in recent months.
Healthcare industry stakeholder advocacy group CAQH launched the program in early 2013, offering a free online enrollment hub to enable providers to register to get the transactions from participating payers, who support the program via an annual fee. Aetna and Cigna were the original participating insurers during 2013.
In January, HIPAA operating rules requiring payers to support EFT and ERA went into effect and multiple insurers have joined during the first six months of 2014. They include WellPoint and 14 affiliates: Unicare, Empire Blue Cross Blue Shield, and Anthem plans in Colorado, Connecticut, Indiana, Kentucky, Maine, Nevada, New Hampshire, Ohio, Virginia, California, Missouri and Wisconsin.
Additional insurers now participating include Blue Cross Blue Shield of Georgia, BlueCross BlueShield of Tennessee, CDPHP, CareCentrix, MAPFRE and Midwest Health Plan. Other payers committed to join in coming months are Kaiser Permanente, Humana, Health Plan of San Mateo and First Community Health Plan. More information on the EFT/ERA service is available here.
CAQH also offers COB Smart, a registry free to providers and sponsored by insurers to give automated identification of patients eligible for health coverage under more than one plan, and which plan pays first. More information is here.
A feature story in the November 2013 issue of Health Data Management explained HIPAA operating rules now in effect and other rules coming in 2016.
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