Region D pushes electronic funds transfer

Monday, January 31, 2005

NASHVILLE, Tenn. - Providers love filing Medicare claims electronically. It’s much faster than snail mail and improves cash flow. But ask them to allow CMS to deposit claim payments directly into their accounts via electronic fund transfer (ETF)and its a whole different story.

In Region D, for example, 87% of claims are filed electronically, compared to only 36% for all payments.

The problem: Providers fear that if Medicare deposits money into their accounts, it can also remove it. That’s a misconception that Region D DMERC, Cigna Healthcare, is out to change, said Roc Via, Region D’s manager for electronic claims transmission. During 25 stops last fall as part of its provider outreach, Cigna talked up the benefits of EFT. The carrier plans to do the same this spring when it visits 17 cities.

The DMERCs use EFT to withdraw money only if it has been deposited to the wrong account, said officials at Cigna and Region B DMERC Administar Federal.

By both filing claims and receiving payment electronically, a provider can reduce significantly the time it takes to get paid, Via said. The math works like this: The DMERCs have 30 days to process a claim. Without EFT, an electronic claim is mailed 14 days after processing and can take up to a week to arrive. If deposited via EFT, payment arrives on the 14th day after processing. For a claim that is mailed in, the DMERCs wait 28 days after processing - not 14 - to make payment. That extra two weeks is an incentive for providers to file electronically, Via said.

“EFT is a win/win alternative for both the DMERC carriers and the DMERC supplier community,” said Via. “The supplier community receives their payments quicker, saves time in not having to go to a bank, and reduces the administrative costs of handling a physical check. The DMERCs benefit from reduced printing and mailing costs. We also benefit due to the reduction in administrative costs to handle physical checks.”