by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
September 25th, 2014
Beware of the changes sneaking in as “money streams” in the name of EFT standards. Virtual Credit Cards are being used in provider’s offices as payments from payers; clearinghouses are starting to offer 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 payment is received with a Virtual Credit Card there will be 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, 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%. This small percentage will not be too bad if associated with a co-pay or small deductible but the larger the amount of money, the more fees 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: MGMA
As with any contract, be sure of what you are signing with Clearinghouse contracts.