Jim Ribelin Will Outline How Collaboration between Government, Banks and Technology Providers Will Drive Adoption of Electronic Healthcare Payments and Significantly Reduce Healthcare Costs in the U.S.
SAN DIEGO--(BUSINESS WIRE)-- HERAE CEO Jim Ribelin will provide expert opinion on options for standards and rules, as well as challenges and opportunities, associated with Electronic Remittance Advice (ERA) and Electronic Funds Transfers (EFT) services for healthcare at the National Committee on Vital and Health Statistics (NCVHS) meeting tomorrow in Washington D.C.
NCVHS is tasked with making certain recommendations to the Secretary of Health and Human Services (HHS) for provisions of the Affordable Care Act specific to Administrative Simplification. Tomorrow’s hearing will explore options for a standard for EFT, operating rules for that standard, and operating rules for the ERA standard.
HERAE (www.herae.com) recommends standards that call for auto reconciliation, single ERA auto posting format, as well as a certification requirement for any company handling ERAs and EFTs. At the same time, HERAE feels that as much as possible should be left to the open market so providers can find the best solutions possible.
“The challenge we currently face with ERA and EFT is adoption by healthcare providers. The entire industry needs to collaborate to drive adoption by providing the necessary rules and standards that work for providers and payers,” says Ribelin. “The problem is that we are looking to penalties to drive adoption of electronic processes, when we haven’t really addressed the day-to-day workflow challenges for providers and payers – namely automated reconciliation – as well as incentives that might encourage early adoption of these electronic key electronic transactions.”
According to Ribelin, the need for a few key industry standards and rules is more urgent than ever due to the recent healthcare reform bill, which picks up where the HIPAA 1996 legislation leaves off with mandates for electronic processes and stiff penalties for non-compliance.
HERAE has been providing electronic payment services to the healthcare industry for more than six years and has become one of the nation’s largest providers of automated ERA and EFT delivery from payers to providers. Its flagship product for healthcare providers, DirectERA, is an all-payer solution for healthcare providers that replaces every aspect of paper-based processes for remittance association, posting, deposit verification, coordination of benefits and refunds with an efficient, inexpensive electronic version that is secure, HIPAA-compliant and requires no software or IT upgrades.
HERAE provides services to health plans with its precision payment solution through IntelliRemit, an electronic remittance and payment processing solution. IntelliRemit reduces bank fees, ensures prompt pay compliance and enhances provider satisfaction with one end-to-end electronic solution. By providing a single bank ACH file and transforming thousands of varying format 835s and ERA files into a single standardized electronic 835 for providers, it can save payers thousands in bank fees, while the automatic payment and remittance re-association vastly improves providers’ reconciliation capabilities.
About HERAE, LLC
HERAE is one of the nation’s largest healthcare payment service providers. HERAE is establishing the nation’s electronic Financial Healthcare NetworkTM by seamlessly and securely connecting payers, healthcare providers, PBMs, pharmacies, and financial institutions with standardized electronic financial healthcare transactions to significantly reduce administrative costs and prevent fraud and waste. HERAE’s automated fraud detection system is the only multi-payer, post-adjudication, pre-payment fraud and waste network for the prevention of billions in healthcare fraud annually. Visit www.herae.com or call 888-41-HERAE (888-414-3723).
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