HEALTHCARE ELECTRONIC PAYMENTS OPTIONS WHICH ONE IS BEST FOR YOUR CLIENTS? Published with permission of the American Medical Association (AMA) The Patient Protection and Affordable Care Act (ACA), which mandated NACHA’s Automated Clearing House (ACH) CCD+ Addenda format as the HIPAA healthcare Electronic Funds Transfer (EFT) standard, goes into effect January 1, 2014. As health plans migrate to electronic claims reimbursements, physicians and other healthcare providers have the power to select the electronic payment option that works best for their needs. For example, all physicians and other health care providers have the right to request and receive claims reimbursements via the healthcare eFT standard (aCH). under HIPaa (45 CFR § 162.925), health plans must deliver the claims reimbursement payment via aCH CCD+ when the provider requests it. But how does this option compare to other electronic payment options? The chart below offers a side-by-side comparison of each of the options mentioned in the final rule: (continued on page 32) THe JOuRNaL OF THe HeaLTHCaRe BILLINg aND maNagemeNT assOCIaTION 31 Funds availability (as measured from the time that a plan initiates payment) average Cost to Receive $2,500 eFT Payment enrollment/ acceptance Risk manual processing for each payment Reassociation with electronic Remittance Information Healthcare EFT Standard (via ACH) Next Day $0.34 (any payment value) One time with each health plan (account information must be provided to each health plan) (Must have bank account) Very low risk with aCH credit payment (Financial institution can support additional account monitoring tools such as debit filters or blocks) None standardized inclusion of TRN Reassociation Data segment in payment (Delivered by financial institution after service is established) Virtual Card 2-3 Business days Percentage of total payment plus a transaction fee example: 3% interchange fee on $2,500 payment and $0.10 transaction fee = $75.10 must have agreement with a merchant card processing provider, and point of sale (POs) processing system/ terminal (Must have a bank account) Higher risk (Card numbers mailed or faxed have information that can be used by anyone with ability to accept card payments) each payment must be manually entered into the POs terminal Not included with payment (Manual access to each EOB through web portal) Wire Transfer same Day (funds irrevocable) $10.73 (any payment value) One time with each health plan (account information must be provided to each health plan) (Must have a bank account) Very low risk None No requirement to include TRN Reassociation Data segment with payment (If included, can be delivered by financial institution after service is established)
Billing_JanFeb14
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