After a survey revealed that about 1 out of 6 physician practices are forced to pay fees for receiving electronic payments from health plans, the Medical Group Management Association called on the government to prohibit the practice.
An MGMA Stat poll taken earlier this month of more than 900 medical practice executives found that 17% indicated that their payments from health plans for medical services via electronic funds transfer (EFT) came with a fee. But 51% said there was no fee attached to the transaction.
The MGMA said some health plans and their contracted payment vendors are taking advantage of physician practices by forcing them to pay fees to receive their payments electronically.
“Even though health plans save money not printing and mailing paper checks, some bad actors are fleecing physician groups by charging them to simply receive an electronic paycheck,” Anders Gilberg, MGMA’s senior vice president for government affairs, said in an announcement.
The Centers for Medicare & Medicaid Services (CMS) established a standard for EFT transactions and supporting operating rules as part of an effort in the Affordable Care Act to decrease healthcare administrative inefficiencies. Since 2014, health plans are required to offer EFT if providers request it.
But Gilberg said it is critical that CMS issue what he called long-overdue guidance explicitly prohibiting health plans and their payment vendors from charging practices for receiving payment electronically.
The transaction fees typically range from 2% to 5% of the total medical services payment, the MGMA said.
In the MGMA poll, more than 32% of respondents said they were unsure if they are charged a fee. But of those who said they did receive fees for EFT payments, almost 60% said the health plans use a third-party payment vendor.
Electronic payments are beneficial to both payers and practices, the MGMA said. They save health insurers millions of dollars by eliminating printing and mailing costs and practices save in the ability to automate the reassociation of the electronic payment with the electronic remittance advice. In addition, practices save in staff time to manually process and deposit paper checks.
The MGMA said CMS recently issued a frequently asked question that was posted on its website that prohibited the fee, but the agency removed the information from its website after just a few days. Until CMS issues guidance prohibiting health plans or their contracted vendors from charging these fees, the MGMA said practice executives must review all payment contracts closely and push back when possible on those who impose fees on basic electronic payments.