May 01, 2018
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement Practice Management
The California Medical Association (CMA) has learned that Aetna will no longer allow contracted physicians to receive payment via check. According to a February 1 notice, Aetna is asking providers to choose one of two options to receive electronic payments – via electronic funds transfer (EFT) or through a virtual credit card (VCC). Providers who do not make a selection will be automatically enrolled in the VCC payment method.
Aetna reports that it began the move to electronic payments in 2009 following the Centers for Medicare and Medicaid Services’ lead and in an effort to reduce costs. Aetna was initially allowing physicians to request a hardship exemption and continue to receive paper checks. However, Aetna will no longer be allowing exemptions; providers will be required to choose to receive electronic payment via EFT or VCC.
Physicians who have not yet enrolled in an electronic payment option will be receiving notices from Aetna with specified enrollment deadlines (dates will vary). Those who do not enroll and select an electronic payment method by the deadline in their notice will be automatically converted to virtual card payments.
What is a virtual credit card?
With the VCC payment method, payors send credit card payment information and instructions to physicians, who process the payments using standard credit card technology.
This method is beneficial to payors, but costly for physicians. Health plans often receive cash-back incentives from credit card companies for VCC transactions. Meanwhile, VCC payments are subject to transaction and interchange fees, which are borne by the physician practice and can run as high as 5 percent per transaction for physician practices. Physicians can avoid these interchange fees by enrolling in EFT.
While there is no requirement that payors continue to issue paper checks, physicians have the right to request electronic funds instead. HIPAA requires all health plans to offer standardized EFT using the Automated Clearinghouse (ACH) Network. Similar to direct deposit, ACH EFT allows health plan payments to be directly paid into a physician’s designated bank account. Each ACH EFT transaction carries only one fee of about $0.34, far less than the potential 5 percent fee charged to VCC transactions. In order to receive ACH EFT, physicians should request and register for this payment method with payors.
Providers who wish to enroll in EFT can do through EnrollHub®, the Council for Affordable Quality Healthcare’s (CAQH) free multi-payor EFT portal. Physicians enrolling in EFT payment will also want to sign up to receive EFT email notifications in order to be notified whenever Aetna transmits a payment. To sign up for EFT email notifications, visit NaviNet’s secured website at https://connect.navinet.net/enroll.
Providers who do not use CAQH or who wish to enroll directly through Aetna can get enrollment forms from www.aetnapaperlessoffice.com. Providers with questions can visit the Aetna website at www.aetna.com/health-care-professionals.html or can contact Aetna at (888) 632-3862.