Healthcare EFT

It’s easy for medical and dental providers to be paid electronically. The Healthcare Electronic Funds Transfer (EFT) standard supports HIPAA-compliant transactions between health plans and providers. Required information travels with the payment, simplifying accounting procedures and reducing administrative costs.

Nacha Operating Rules

Nacha partners with the healthcare industry, using the Nacha Operating Rules and Guidelines to support the standardization of payments between health plans and providers. The adapted set of rules standardizes healthcare EFTs, which is critical to the healthcare industry’s payments operation.
 
This collaboration between Nacha and the healthcare industry came about as a result of the Patient Protection and Affordable Care Act (ACA), which mandated the identification of a healthcare EFT standard and the implementation of operating rules for all electronic healthcare transactions by January 1, 2014. By supporting the healthcare EFT standard, Nacha helped:

  • Make EFT more efficient by leveraging the ACH Network and Nacha’s CCD+ as the healthcare EFT standard.
  • Reduce administrative costs for doctors and hospitals.
  • Save an estimated 800,000 pounds of paper by replacing paper checks with electronic transfers.

Healthcare Partnerships

To develop new healthcare operating rules in support of the CCD+ standard, Nacha worked with the Committee on Operating Rules for Information Exchange (CORE), a part of the Council on Affordable Quality Healthcare (CAQH).
 
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. 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.

To find resources to support adoption and implementation of the Healthcare EFT Standard and ERA, visit the:

Healthcare Resource Center

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