We've been talking about the alignment of healthcare and banking (Financial Services and Health Insurance payers) since the Affordable Care Act (ACA) passed . . . it actually happens in 2014 and here is the beginning of Medical Banking. A new report from the Workgroup for Electronic Data Interchange (attached) covers the new electronic fund transfer and electronic remittance advice HIPAA transactions that were mandated in January 2014.
Under the Affordable Care Act, health plans must support EFT upon provider request, and Medicare will require its use. Reform-authorized “operating rules” to make the EFT and ERA transactions more standardized also take effect in January.
The report walks through the EFT and ERA regulations, explains how business processes will change for health care organizations and their trading partners, and gives examples of best practices for implementing the transactions and their operating rules.