Claims Payment Automation HOW TO MAKE AN EDUCATED CHOICE any providers have found that claims paid by virtual card have increased this year. As a result, the fees they pay for card acceptance have skyrocketed. Does your practice have a planned response to virtual card claims payments? Do you know your rights under the Affordable Care Act (ACA) for a less expensive form of claims payment? under the aCa, providers have a number of electronic payment options available to them for claims reimbursements. Options include the healthcare electronic funds transfer (eFT) standard via automated clearinghouse (aCH), credit and virtual card payments, and wire transfers. each payment type has unique attributes and associated costs, and providers have the ability to choose the payment type that best suits the needs of their practice. The Healthcare EFT Standard similar to direct deposit, eFT via aCH enables health plan-to-provider payments that are processed over the aCH network using the healthcare eFT standard, or the NaCHa CCD+ addenda. Payments made this way include a TrN reassociation trace number, which is used to tie the aCH payment to the appropriate electronic remittance advice (era). This allows for the automatic reconciliation of the eFT payment with the era. Other EFT Payment Options Health plans may offer other eFT payment options, including wire transfer or virtual cards, in addition to the healthcare eFT standard via aCH. some health plans are replacing all check claims payments with virtual card payments without prior authorization from the provider. a virtual card is a single-use credit card transaction that must be manually entered into the provider’s point of sale terminal and manually reconciled with an explanation of benefits (eOB). FEATURE sTOrY Providers should make an informed decision on accepting virtual card claims payments, as these payments shift the cost of payment processing from the health plan to the provider. Credit card rules do not require a provider to accept virtual card payments just because they accept credit cards for patient payments. Costs of EFT Payments The costs associated with eFT payments can vary greatly. With aCH payments, providers, as small businesses, generally pay their financial institutions a per-transaction fee for each aCH payment directly deposited to their accounts. The average per-transaction cost is $0.34, regardless of the payment amount. Wire transfers and virtual cards are more costly. The fees asso- THe jOurNal OF THe HealTHCare BIllINg aND maNagemeNT assOCIaTION 21 By Priscilla Holland, AAP M Under the ACA, providers have a number of electronic payment options available to them for claims reimbursements.
Billing_NovDec14
To see the actual publication please follow the link above