Electronic Funds Transfer (EFT) electronically deposits claims payments directly into providers’ or health plan members’ bank accounts, eradicating the need to mail paper checks.
Electronic Remittance Advice (ERA) is the electronic equivalent of an “explanation of payment,” or EOP. An ERA provides details on how claims were paid or why they were denied.
The technologies and business processes used to move healthcare payments in America today are undergoing a fundamental change. Traditionally, healthcare payments from claims payers, such as insurance companies, to healthcare providers, such as doctors’ offices and hospitals, have been entirely paper-based. However, the convergence of Consumer Directed Healthcare payments and Traditional Healthcare payments have burdened the claims systems of today’s Healthcare Payer, and the cost of paper claims payments is skyrocketing.
EFT and ERA solutions can provide substantial cost savings to both claims payers and healthcare providers through operational efficiencies and streamlined processes. The benefits of electronic claims processing are already acknowledged in the healthcare industry, and the search is on for reliable electronic payment solutions that reduce post-adjudication costs and vastly improve payer-provider relationships.