The U.S. Department of Health and Human Services (HHS) has released new standards for health care electronic funds transfers and remittance advice. The rules adopt streamlined standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives. The new tracking system will allow health care providers to eliminate costly manual reconciliation that must currently be done with the current system.
These regulations result from provisions in the Affordable Care Act and build on administrative simplification rules introduced in the Health Insurance Portability and Accountability Act (HIPAA). The regulations are effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014. The public may submit comments on these rules on or before March 12, 2012.