Key Considerations for Achieving ERA/EFT

On January 1, 2014, all payers will be required to support electronic funds transfer (EFT) and electronic remittance advice (ERA). When evaluating how to achieve ERA/EFT, one of the first decisions a payer will need to make is to “build or buy” – whether to use internal resources to build ERA/EFT capability or to work with a third-party vendor.

Regardless of which model a payer follows to achieve ERA/EFT, there are several key considerations that need to be included in the

Tagged Administrative Costs, Affordable Care Act, Best Practice, CAQH, Compliance, CORE, ERA/EFT, healthcare payments, healthcare reform, payer-to-provider payments

What the New EFT Regulations Mean for You

Guest Blogger: Bill Marvin, President & CEO, InstaMed

In an earlier post, I commented on the HHS interim final rule adopting electronic funds transfer (EFT) standards, which was released in January 2012. In the post, I outlined the following changes needed in order for the new EFT regulations to truly improve efficiency and deliver cost savings for healthcare payers and their provider networks:

1. Add a Trace Number Requirement

The rule should require that the EFT and the electronic remittance advice (ERA) have

Tagged Administrative Costs, Affordable Care Act, Best Practice, CAQH, Compliance, CORE, ERA/EFT, healthcare payments, healthcare reform, Medical Loss Ratio, patient responsibility, payer-to-provider payments, payers, providers, reconciliation, remittance, reporting

Electronic Payments: 4 Requirements to Integrate EFT with ERA

Healthcare reform is a major factor driving change in payer-to-provider payments, including the medical loss ratio (MLR) requirement in PPACA. To reduce administrative costs and meet the MLR mandate, payers are implementing more efficient payment delivery methods. One such method is the offering of ERA/EFT, which combines both the payment and the healthcare payment information to enable provider funding, posting and reconciliation. While many payers have been sending providers ERAs (electronic remittance advice) for years, it’s time for payers to

Tagged Affordable Care Act, CAQH, Compliance, CORE, EHNAC, ERA/EFT, healthcare payments, healthcare reform, HIPAA, ICD-10, Medical Loss Ratio, NACHA, payer-to-provider payments, payers, PCI, providers, remittance, SSAE 16

Blog Post Topic: CORE

Key Considerations for Achieving ERA/EFT

What the New EFT Regulations Mean for You

Electronic Payments: 4 Requirements to Integrate EFT with ERA