HHS proposes electronic fund transfers to reduce admin costs
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New standards for electronic funds transfers in healthcare, required by the Patient Protection and Affordable Care Act, will reduce up to $4.5 billion of administrative costs for doctors and hospitals, private health plans, states and other government health plans over the next 10 years, according to estimates published by HHS.
Combined with the powers of a final rule, issued July 2011, which set industry-wide standards for how health providers use electronic systems to determine a patient’s eligibility for health coverage and check on the status of a health claim, the two regulations are projected to save the healthcare industry more than $16 billion over the following decade.
The rule issued adopts standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a remittance advice notice, the HHS stated.
The rule utilizes a trace number that automatically matches a remittance advice and electronic funds transfers payment from a health plan when a provider submits a claim electronically.
The regulation became effective January 1. All health plans covered under HIPAA must comply by January 1, 2014.