A new regulation announced Thursday by the US Department of Health and Human Services establishes Electronic Funds Transfers (EFT) standards that, when implemented by health plans, will save physician practices and hospitals between $3 billion to $4.5 billion over the next ten years. The rule—the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice—creates streamlined standards for a health plan to follow when paying claims to a provider electronically and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives.
The NCMS is a strong proponent of federal initiatives to alleviate the administrative burden placed on physician practices. HHS Secretary Kathleen Sebelius said, as a result of the rule, health care professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients.
Physicians spend about 12 cents of every dollar they receive from patients to cover the costs of filling out forms and performing other administrative tasks, according to a May 2010 study in the journal Health Affairs. Researchers found that simplifying these systems could save four hours a week of a physician’s professional time and five hours of support staff time.
The new EFT rule is the second in a series of regulations required by the Patient Protection and Affordable Care Act. The first—Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status—was adopted last June and set standards for how physicians and other health care providers use electronic systems to determine a patient’s eligibility for health coverage and check on the status of a claim.
HHS is working on further administrative simplification rules that will include a standard unique identifier for health plans, a standard for claims attachments, and requirements that health plans certify compliance with all HIPAA standards and operating rules.
Click here to view the HHS News Release on streamlining electronic funds transfers in health care.