by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
July 31st, 2014
Beware of the changes sneaking in as “money streams” in the name of EFT standards. I am beginning to see Virtual Credit Cards used in provider’s offices as payments from payers. I am also hearing clearinghouses are offering this service as well.
Effective January 1, 2014 health plans were required to offer electronic funds transfer (EFT). While healthcare is shifting from paper to electronic there are some things to keep in mind about your rights and what is taking place What you are not being told is that some clearinghouses are also using this method as an EFT process. If you are being paid with a Virtual Credit Card you will be paying a percentage based processing cost associated with the amount of funds issued as well as a processing fee. In the EFT rules entities do have a choice to use ACH or other forms of payment. Be sure to research your options prior to signing up with your clearinghouse for electronic payments, I would suggest ACH EFT’s would be more financially beneficial as they charge as little as .35 per transaction.
Providers are going to notice these unnecessary fees attributed to electronic funds transfer (EFT) payments with fees as high as 5% from what I hear. 5% will not be too bad if associated with co-pay or small deductible but the larger the amount of money the more fees you will be charged. We also need a clear definition of what constitutes “excessive Fees” for EFT transactions under the EFT standards.
MGMA (Medical Group Management Association) believes certain health plans and clearinghouses are not complying with the true intent of EFT standards and operating rules as set by the Affordable Care Act, and are taking unfair advantage of practices. MGMA has appealed to CMA and urges a release on additional guidance on this issue. For more information on the letter to CMS read here, (Click Here).
As with any contract be sure of what you are signing when you sign your Clearinghouse contracts.
References:
Quick, Current, Complete - www.findacode.com