- The Workgroup for Electronic Data Interchange (WEDI), a formal advisor to HHS on the use of health IT, announced Wednesday the release of a set of healthcare industry best practices for electronic payments.
- The recommendations were developed by a group of representatives from the health insurance, provider, clearinghouse, banking and government sectors in order to addresses concerns raised by respondents of a WEDI survey in early 2016, WEDI said.
- The health IT authority is looking to drive increased use of Automated Clearing House (ACH) Electronic Funds Transfer (EFT) transactions in healthcare, and establish guidelines for alternative payment options, including virtual credit cards.
The industry has an incentive to further embrace ePayment technology for the sake of savings, though some barriers need to be addressed, potentially through the adoption of the proposed principles.
WEDI argues the benefits of such technology are well established in healthcare, and that the use of ACH EFT and electronic remittance advice (ERA) standards and operating rules is worth savings of up to $4.5 billion for government and private health plans, hospitals, physician practices, and others over ten years.
The principles have already received support from the Medical Group Management Association (MGMA). “Industry bad actors are effectively penalizing physicians up to 5% by reimbursing them with credit card or EFT payments that charge excessive fees," MGMA President and CEO Halee Fischer-Wright said in a prepared statement. "We are hopeful that payers and other key industry stakeholders will embrace the WEDI ePayments Principle.”
One issue standing in the way is slow provider adoption due to reluctance to change current workflows or pay for supporting software. "We are hopeful that the ePayments Principles will serve as a catalyst for increased industry use of this important transaction," stated Jay Eisenstock, head of provider solutions at Aetna and co-chair of the WEDI ePayments Taskforce.
Other issues identified in WEDI's survey were that nearly 25% of provider organizations said they were required to pay fees for use of ACH EFT transactions, and that 40% were required to take a health plan payment in the form of a “virtual” credit card that leaves the provider responsible for all transaction fees.
Fourteen recommended principles aim to address these issues, in part by promoting transparency around the process. Among those principles:
- Providers should not be subject to any hidden fees.
- Explicit agreement should be received before any ePayment other than ACH EFT is used.
- Any payment-related entities offering an ACH EFT payment option should do so without any origination fees.