We follow the ERA and EFT method of posting payments
Health and Human Services Secretary Kathleen Sebelius
released a new rule she says will cut red tape for doctors, hospitals
and health plans. In combination with a previously issued regulation,
she estimates the rule will save up to $9 billion over the next 10
years.
The regulation adopts operating rules for making healthcare claim payments electronically and describing adjustments to claim payments.
“These new rules will cut red tape, save money, and ensure doctors spend more time seeing patients and less time filling out forms,” said Sebelius.
Studies have found that the average physician spends three weeks a year on billing and insurance related tasks, and, in a physician’s office, two-thirds of a full-time employee per physician is necessary to conduct these tasks. Many physician practices and hospitals receive and deposit paper checks, and manually post and reconcile the healthcare claim payments in their accounting systems.
“These new rules will cut red tape, save money, and ensure doctors spend more time seeing patients and less time filling out forms,” said Sebelius.
Studies have found that the average physician spends three weeks a year on billing and insurance related tasks, and, in a physician’s office, two-thirds of a full-time employee per physician is necessary to conduct these tasks. Many physician practices and hospitals receive and deposit paper checks, and manually post and reconcile the healthcare claim payments in their accounting systems.
By receiving payments electronically and automating the posting of
the payments, a physician practice and hospital’s administrative time
and costs can be decreased.
The operating rules build upon industry-wide healthcare electronic fund transfer (EFT) standards that HHS
adopted in January of this year. Together, the previously issued EFT
standards and the EFT and electronic remittance advice (ERA) operating
rules announced today are projected to save between $2.7 billion and
more than $9 billion in administrative costs over 10 years by reducing
inefficient manual administrative processes for physician practices,
hospitals, and health plans.
Operating rules include best business practices on how electronic
transactions are transmitted and often target obstacles that physician
practices and health insurers have with using electronic transactions
For instance, the rule announced Aug. 7 requires insurers to offer a
standardized, online enrollment for EFT and ERA so that physicians and
hospitals can more easily enroll with multiple health plans to receive
those transactions electronically. The rule also requires health plans
to send the EFT within a certain number of days of the ERA, which helps
providers reconcile their accounts more quickly.
Today’s rule, Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds Transfers and Remittance Advice Transactions were developed through extensive discussions with industry stakeholders, Sebelius said. The rule adopts the Council for Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange (CAQH CORE) Phase III EFT & ERA Operating Rule Set.
The regulation will be effective upon its publication in the Federal Register on Aug. 10, 2012. The comment period closes on Oct. 9, 2012.
The compliance date for operating rules for the health care electronic funds transfers and remittance advice transaction is Jan. 1, 2014.
Today’s rule, Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds Transfers and Remittance Advice Transactions were developed through extensive discussions with industry stakeholders, Sebelius said. The rule adopts the Council for Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange (CAQH CORE) Phase III EFT & ERA Operating Rule Set.
The regulation will be effective upon its publication in the Federal Register on Aug. 10, 2012. The comment period closes on Oct. 9, 2012.
The compliance date for operating rules for the health care electronic funds transfers and remittance advice transaction is Jan. 1, 2014.
Source From Physicians Practice
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