decisionhealth Newsletters, Part B News - 2012 Issue 8 (August)
Profit from HHS’ new EFT/ERA rules for payers; test vendor readiness
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Article Overview
This article covers newly finalized HHS operating rules related to electronic funds transfer (EFT) and electronic remittance advice (ERA). It focuses on why the changes matter to practices, the administrative and workflow issues they are intended to reduce, and the questions practices should ask vendors about readiness, testing, and integration support. The piece is aimed at practice managers, billing teams, and organizations evaluating software or vendor transitions in the context of payer transaction automation.
Why This Topic Matters
The rules affect how practices receive and reconcile payment and remittance information, which can influence administrative workload, cash flow, and software planning. Readers can use the article to understand the operational impact of the rules and to evaluate whether their current systems are prepared for the transition.
Article Sections
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Practice management
Introduces the new HHS rule and its significance for practice management systems and payer transaction processes. It frames the discussion around vendor readiness and the operational impact on practices.
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Query your vendor on EFT, ERA plans
Outlines the types of vendor questions practices should consider when assessing readiness for the new operating rules. It also discusses software selection, testing, and integration considerations for organizations evaluating solutions.
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EFT, ERA obstacles and solutions
Summarizes common administrative challenges associated with EFT and ERA workflows and describes the broad categories of changes addressed by the rule. The section contrasts existing process problems with the corresponding rule-based improvements.
What You Will Learn
- How the HHS EFT and ERA operating rules affect payer and practice workflows
- What kinds of vendor readiness considerations matter before the effective date
- Which administrative pain points the rule is intended to reduce
- How software and workflow planning can influence automation and reconciliation
- What broad categories of payer enrollment and remittance changes are discussed
Who Should Read This
- Practice managers
- Billing and revenue cycle staff
- Medical group administrators
- Healthcare IT and software buyers
- Vendor and payer operations teams
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