Fifteen months have passed since insurers were mandated to adopt HIPAA operating rules by January 2014 that increase standardization of electronic funds transfers and electronic remittance advice transactions, and offer them to providers who want to use the transactions.
The idea was to have everyone playing by the same rules, making it easier for providers to understand what services are being reimbursed and to offer a Holy Grailautomated posting of remittance advice to providers financial administrative systems.
It hasnt quite worked out that way yet, as not all payers are offering the transactions as required, and many providers arent asking for them, says Tim McMullen, executive director of the Healthcare Administrative Technology Association (HATA), which represents practice management software vendors.
In conjunction with the HIMSS15 Conference and hoping to attract stakeholders attending the big show, HATA on Sunday April 12 will host an EFT/ERA summit at the Silversmith Hotel in Chicago. The goal is to bring together stakeholders to identify barriers preventing full use of the transactions, gain commitments to resolve the barriers and develop strategies to increase payer and provider adoption.
There are perceptions on the provider side that that the process to set up getting EFT/ERA transactions is difficult that must be addressed, McMullen acknowledges. The paperwork is more complicated than it has to be and is a stumbling block.
But there also is an erroneous belief in the provider community that if an insurer overpays for a claim, it can reach into a providers bank account and recoup the overpayment. Such recoupment, McMullen says, clearly is not permitted.
More information on the April 12 summit and an April 8 Web seminar, as well as a HATA white paper, Promoting Administrative Simplification through ERA and EFT Adoption: An Industry Call to Action, is available here.
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