States mandating era or eft ad aware plus not updating
Our rules, in conjunction with the healthcare industry operating rules for EFT and electronic remittance advice (ERA), will help result in the continued administrative simplification by health care providers and health plans.If you would like request an enhancement to the Healthcare EFT standard, please fill out our form.
Nacha’s rules, which were implemented in September 2013, allow us to identify and track healthcare payments via ACH and provide for the automatic reassociation of healthcare payments with payment information.
Under HIPAA, all health plans, including Medicare, are required to use claims adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) instead of property codes, to explain any adjustment in the claim payment.
X12 is the recognized code set maintainer for the CARCs and RARCs.
So it’s important to examine all options to reduce the rising healthcare reimbursement and administrative costs that healthcare payers are facing .
Of the ever-increasing healthcare costs, how much is attributable to administrative and payment expenses?Requests for codes must include suggested wording for the new or revised message, and an explanation of how the message will be used and why it is needed.