Proposed billing regulation would cut costs and red tape for providers, HHS says

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HHS Secretary Kathleen Sebelius
HHS Secretary Kathleen Sebelius

Providers will save time and money through a proposed regulation that would allow providers to electronically post and reconcile payments from health plans, government officials said Tuesday.

Health and Human Services Secretary Kathleen Sebelius touted the rule as something that would “cut red tape, save money.” The newly proposed rule builds on wide healthcare electronic fund transfer (EFT) standards and EFT electronic remittance advice (ERA) operating rules adopted in January.

Essentially, the rule would require payers to offer a standardized, online enrollment for EFT and ERA so that HIPAA-covered providers can more easily enroll with multiple health plans to receive those transactions electronically. Additionally, it requires health plans to send a transfer within a certain amount of days of the ERA, which would help providers reconcile their accounts more quickly.

Providers stand to see a net savings of between $300 million and $3.3 billion over 10 years, according to the Centers for Medicare & Medicaid Services.

As proposed, providers would have to comply with the new rule by Jan. 1, 2013. Click here to review the rule, and click here for the CMS fact sheet.

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