HHS rules governing electronic fund transfer could save hospitals $9B

The U.S. Department of Health & Human Services has released new rules governing electronic fund transfer (EFT) and remittance advice transactions, a move HHS Secretary Kathleen Sebelius says will save doctors, hospitals and insurers up to $9 billion over the next 10 years.

The new rules eliminate administrative obstacles to electronic claim payments and adjustments to those payments, HHS said in yesterday's announcement. The savings come when combined with industrywide EFT standards adopted in January, HHS said.

EFT takes the place of manual deposits of paper checks and manual posting and reconciling of claim payments. Electronic claims and adjustments processing can save two-thirds of a full-time employee per physician in the typical practice, as well as paper, printing and mailing costs, according to HHS.

The ongoing rule change could be good news for struggling medical practices. The American Medical Group Association's annual compensation and financial survey, released just last week, showed a national median loss of $1,235 per physician.

Insurers will have to offer standardized online enrollment for EFT and electronic remittance advice (ERA) transactions under the new rules, allowing physicians and hospitals to more easily conduct electronic transactions with multiple health plans, according to the announcement.

The interim final rule, "Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds Transfers and Remittance Advice Transactions," is posted on the Federal Register, with a compliance date of Jan. 1, 2014. Comments will be accepted through Oct. 9.

There's more to come, HHS says in a technical fact sheet. HHS still plans to adopt a standard unique identifier for health plans, a standard for claims attachments and requirements for health plans to certify compliance with HIPAA and operating rules.

To learn more:
- read the HHS announcement
- see the Federal Register filing
- check out the technical fact sheet

AHIP WEBINAR

Fuel Top Line Growth and Increase Membership

In this webinar, payers can learn how to accelerate the sales pipeline and grow membership across all health insurance market segments using comprehensive sales technologies.