The Workgroup for Electronic Data Interchange (WEDI) has released guidance on the HIPAA requirements for electronic fund transfer (EFT) and electronic remittance device (ERD) transactions.
"Our healthcare environment is changing so rapidly that it's very important to be able to share information and ensure that all parties involved in the changes not only understand the requirements, but the impact to their business and their trading partners' businesses," Pamela Grosze, vice president, PNC Bank, Healthcare Operations Payer Services, said in an announcement.
Among the challenges are fees that banks may charge for EFT processing, and for providers working with multiple payers, some may offer EFT and others might not. Plus they might have different processes, some electronic some manual, the paper says.
Fifteen healthcare professionals were part of WEDI's EFT subworkgroup that produced the document. It also involved the National Automated Clearing House Association in the collaboration.
The paper outlines EFT and ERA regulations and provides specific examples as organizations implement new processes to meet the regulations. The document can be downloaded from the WEDI website.
Beginning January 2014, HIPAA will require all payers to offer EFT and Medicare will only reimburse providers through EFT. New EFT rules from the Department of Health and Human Services are expected to save doctors, hospitals and insurers up to $9 billion over the next 10 years.
It says electronic claims and adjustments processing can save time by two-thirds of one full-time employee per physician in the typical practice, as well as paper, printing and mailing costs.
"As customers of financial institutions, healthcare providers and payers need assurances that financial institutions can safeguard protected health information with appropriate technology systems, infrastructure, and procedures for risk management and incident management," the Healthcare Information and Management Systems Society said last fall when it issued recommendations to the proposed rules.
A new tool from the tool from the Council for Affordable Quality Healthcare allows providers to enroll in EFT with multiple payers through a single, online process.