How to Reassociate EFT/ACH Payments to ERAs in 2014

The healthcare industry has high hopes that federal health reform will be the impetus to finally reducing the sky-high administrative costs that burden payers and healthcare providers alike. The industry is particularly keen on mandates for electronic transactions such as the Healthcare Operating Rules for EFT & ERA and NACHA’s TRN Association defined by X12 835 TR3 V5010. These new standards are aimed at streamlining the reassociation of payments and remittances (remittances describe the payment details of payer payments).

These initiatives are great steps for the industry, but there are significant limitations that need to be addressed.

The underlying problem that federal health reform and the NACHA rules changes don’t address is that electronic remittance advices (ERAs) and electronic funds transfers (EFTs) are sent from health plans to providers through separate channels.

With no automated bridge between the EFT/Automated Clearing House (ACH) and ERA data sets, providers will still face challenges in reconciling payments and tracking receivables...

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