States mandating era or eft
For more guidance on standardized EFT/ERA enrollment data elements please refer to the CAQH CORE operating rules found at Phase III EFT and ERA Operating Rules.Health plans are required to input the X12 835 TRN Segment into Field 3 of the Addenda Record of the CCD Addenda.According to the Kaiser Family Foundation, annual healthcare expenditures represent over .6 trillion in the United States, of which close to 10 percent is spent on healthcare administrative costs.To help address this issue, on January 1, 2014, a provision under the Administrative Simplification Section of the Affordable Care Act (ACA) — known as the Adoption of Standards for Health Care Electronic Funds Transfers (EFTs) and Remittance Advice — went into effect. Department of the Treasury estimates that electronic payments will save the government 12.5 percent on every Medicare claim paid by EFT versus check as a result of the mandate. How much could your organization save through this initiative?Healthcare reimbursement costs are rising, while insurance premiums are under downward pressure from highly competitive marketplace exchanges and high deductible health plans.And just like there is no single cause for the rising costs of healthcare, there will be no single solution either.
An electronic funds transfer, or EFT, is the electronic message health plans use to order a bank to transfer funds electronically to a provider’s bank account to pay for health care services.So it’s important to examine all options to reduce the rising healthcare reimbursement and administrative costs that healthcare payers are facing .Of the ever-increasing healthcare costs, how much is attributable to administrative and payment expenses?Additionally, the healthcare payer should use a trace number (TRN) to help tie the ACH payment back to the 835 ERA.A single ACH payment can represent many claim reimbursements contained with the corresponding 835.