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HHS moves to streamline electronic payments for physicians


The government is trying to make it easier for you to submit claims payments to insurance companies electronically. Find out how your practice can benefit.

The government is trying to streamline the process by which insurance companies pay you.

Last week the U.S. Department of Health and Human Services (HHS) announced a new rule that, in combination with a regulation issued earlier this year, is designed to make it easier to submit claim payments electronically.

The rule includes best business practices for transmitting electronic transactions and tries to remove obstacles to their use among doctors and insurance companies. For example, the rule requires insurers to offer standardized, online enrollment for electronic fund transfers (EFTs) and electronic remittance advice (ERA), so that physicians can more easily enroll with multiple health plans to receive payments electronically.

“These new rules will cut red tape, save money, and ensure doctors spend more time seeing patients and less time filling out forms,” HHS Secretary Kathleen Sebelius said in a statement.

Many physicians’ practices receive and deposit paper checks and manually post and reconcile their claims payments in their accounting systems. HHS cites studies showing that the paperwork involved with those processes requires the equivalent of two-thirds of a full-time employee per physician in the typical practice, as well as up to 3 weeks of a physician’s time. Receiving payments electronically and automating the posting of payments will save time and reduce costs, HHS says.

In January, HHS adopted industry-wide EFT standards. The department estimates that those standards, combined with the EFT and ERA operating rules announced last week, will save $2.7 billion to $9 billion in administrative costs over the next 10 years.

The rule went into effect August 10, and the comment period on it closes October 9. The rule can be viewed at The compliance date is January 1, 2014.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
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© National Institute for Occupational Safety and Health
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© National Institute for Occupational Safety and Health