Understanding Healthcare EFTs

Healthcare Electronic Funds Transfers (EFTs) offer healthcare providers a safe, convenient, and timely alternative to paper checks or card payments for healthcare claims payments.

What is the Healthcare EFT Standard?

An EFT is the electronic exchange or transfer of funds from one account to another. EFTs serve as an efficient means of payments for providers and their practices. Per the Patient Protection and Affordable Care Act, the NACHA ACH CCD+ is the healthcare standard.

To receive EFTs, providers can request delivery of claims payments via the healthcare EFT standard, and health plans must comply.

Benefits of Using the Healthcare EFT Standard

Benefits to using the healthcare EFT standard are many:

  • Easy Automatic Payments — Receiving healthcare EFTs via ACH is as quick as receiving Direct Deposit.
  • Smart, Cost-Effective Choice — The cost of claims via ACH is, on average, only $0.34 versus $10.73 or more for other EFT payment types.
  • Improved Efficiencies — Healthcare EFTs via ACH ensure funds are available up to 7 days faster than with paper checks, improving cash flow.
  • Safe and Secure — Checks continue to be the dominant payment form targeted by fraudsters. Replacing all checks with healthcare EFTs via ACH is the single best way to combat fraud.
  • HIPAA EFT Transaction — As a HIPAA transaction, under 45 CFR 162.925, providers can request delivery of the healthcare ET standard and health plans must comply.
  • Automatic Reasssocation — Only healthcare EFTs via ACH offer providers the ability to automatically reassociate remittance information.

How to Enroll to Receive the Healthcare EFT Standard

  1. Contact health plans — Choose the healthcare EFT standard (the ACH CCD+ Addenda) for payment.
  2. Provide payment information to health plans — Enroll in EFT with a few health plans each week. Start with the health plans that represent the largest percentage of your business.
  3. Receive payments directly in your bank account — In the same ways employees receive payroll via Direct Deposit, receive your claims payments on time, every time.
  4. Receive the Reassociation Trace Number directly from your bank — Contact your bank to receive the Reassociation Trace Number to begin automatically matching remittance information with payments.

Download Understanding the Healthcare Electronic Funds Stransfer (EFT) Standard, along with a comparison of EFT payment options, in PDF format.