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HHS rule on electronic funds transfers in healthcare to save $4.5 billion

January 6, 2012
by Kevin Kolus
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New standards for electronic funds transfers in healthcare, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for providers over the next 10 years, according to the U.S. Department of Health and Human Services.

The standards build upon regulations published earlier this year that set industry-wide standards for how health providers use electronic systems to determine a patient’s eligibility for health coverage and check on the status of a health claim.

“Thanks to the Affordable Care Act, healthcare professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients,” HHS Secretary Kathleen Sebelius said in a statement.

The regulation adopts standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically and to issue a remittance advice notice. A trace number automatically matches a remittance advice and electronic funds transfers payment from a health plan when a provider submits a claim electronically.

The interim final rule is effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014, HHS said.

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