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EFT

New EFT & ACH Standards Will Streamline Payments, Create Reconciliation Problems

June 10, 2014

Established in 1996, HIPAA standards addressing major transaction types in the revenue cycle were not enough to achieve industry Administrative Simplification. Currently, less than one-half of medical claim reimbursements are made electronically. The Affordable Care Act (ACA) is pushing for transformation by implementing compliance initiatives including the mandated 5010 and Healthcare Operating Rules for EFT & ERA. These are driven by CAQH-CORE (The Council for Affordable Quality Healthcare – Committee on Operating Rules for Information Exchange).

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A Good Read… NACHA Rules Book

January 14, 2014

I just received my notification email from NEACH (New England ACH) to download the 2014 NACHA Operating Rules & Guidelines. I have to say, this is good reading! As you may now, “the 2014 NACHA Operating Rules and Guidelines is the definitive source for information about the exchange and settlement of transactions through the ACH Network. The NACHA Operating Rules provide the legal framework for the ACH Network in simple, clear and consistent language. The NACHA Operating Guidelines contain complete discussions of each ACH Network participant type and its role and obligations, as well as detailed overviews of Standard Entry Class Codes.

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Outsourcing Healthcare Payment Functions: Not Just for Banks Anymore, But Billers Too!

December 19, 2013

Healthcare providers are now outsourcing more of their revenue cycle functions. Large banks saw this medical banking potential several years ago and moved quickly to offer added-value services such as EOB conversion and treasury management capabilities specifically for this niche.

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Who’s Winning in this New Era of Healthcare Revenue Cycle Management? Consultants…

October 16, 2013

According to a new survey by Black Book, the consulting business is booming in healthcare revenue cycle management; and rightly so! Challenges that executives cited for updating RCM projects include: 77 percent have not begun a strategic plan for transforming RCM solutions for known deadlines because of lack of internal experts to do so and 80 percent of CIOs said they do not have the IT staff in-house to transform RCM end-to-end.

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Survey Opportunity: What is needed for EFT/ACH Reassociation to ERA’s

July 25, 2013

You’re a healthcare payments professional and by now, you probably have an opinion on the topic of reassociation. You’ve seen the Orbograph white paper, How to Reassociate EFT/ACH Payments to ERAs in 2014, and see why the industry needs to make a move in this area. If you haven’t read it, now’s your chance! Or check out http://www.caqh.org/. There’s only 161 days left to prepare for implementation deadline for federally-mandated CAQH CORE EFT and ERA Operating Rules…

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