October 21, 2021
Area(s) of Interest: Practice Management
Aetna recently announced it would begin to transition to an all-electronic payment and remittance process in September 2021. The payor said it plans to transition to the exclusive use of electronic remittance advices (ERA), electronic funds transfer(EFT) and electronic explanation of benefit (EOB) statements for all participating and non-participating providers by September 2022.
For claims payment details, Aetna said providers have the option to either obtain electronic explanation of benefits (eEOBs) through the Availity web portal or to sign up to obtain electronic remittance advices (ERAs) from any of Aetna’s directly connected vendors through Change Healthcare’s payor enrollment services.
Providers will have two options to receive electronic payments – via EFT or through a virtual credit card (VCC). Providers who do not enroll in EFT will automatically receive payments through the VCC payment method. Providers who wish to enroll in EFT can do so through Change Healthcare payor enrollment services.
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% per transaction. 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% fee charged to VCC transactions. To receive ACH EFT, physicians should request and register for this payment method with payors.
For more details visit aetnapaperlessoffice.com.
Providers with questions can contact Aetna at (888) 632-3862.