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Physicians and other health providers are now using this industry standard for provider data collection



2013 Press Releases


New Online Tool Lets Providers Enroll in EFT
with Multiple Payers through a Single, Online Process

CAQH Solution Facilitates Compliance with EFT Mandate,
Eliminates Administrative Redundancies and Saves Costs

WASHINGTON, DC – February 5, 2013 – CAQH® announced today the launch of a new, universal electronic funds transfer (EFT) enrollment tool for providers that facilitates the use of electronic payments between payers and providers by offering a single point of entry for adopting EFT. By streamlining and automating the EFT enrollment process, the tool creates efficiencies and cost savings for both payers and providers by eliminating the need for providers to enroll in EFT separately for each health plan in which they participate.

Beginning January 2014, all payers will be mandated to offer EFT under the requirements of the Patient Protection and Affordable Care Act (ACA) and Medicare will only reimburse providers through EFT. However, the Department of Health and Human Services (HHS) reports that only 32 percent of healthcare claims were paid electronically in 2010, partially due to the current cumbersome and burdensome enrollment processes which require that providers enroll separately with each payer. The switch to EFT for provider reimbursement will eliminate the need for redundant paperwork, reduce the time spent on printing, mailing and receiving checks, lower lockbox fees, as well as enable tighter security on monetary transactions.

“CAQH’s universal EFT tool offers an efficient and effective way for providers to easily – and at no cost to them – adopt electronic payments,” said Susan Turney, MD, MS, FACMPE, FACP, President and CEO of MGMA-ACMPE, the Medical Group Management Association (MGMA) and the American College of Medical Practice Executives (ACMPE). “This is a win-win for providers, payers and patients themselves as administrative savings can be redirected toward care delivery.”

The CAQH EFT enrollment tool allows providers to enter their EFT enrollment information into a single, secure, online utility and select the payers to which their information should be sent. Payers receive the enrollment information electronically from CAQH, enabling providers to complete the process once. In addition, providers can go into the tool at any time, make changes and easily distribute those changes to the applicable payers if needed. There is no cost for providers to use the service. Participating payers support the operations of the service through a low annual participation fee.

Currently, Aetna and Cigna Health Plans, which have more than 800,000 providers in each respective network, offer EFT enrollment through the CAQH online tool.

“Moving from a redundant, paper-based EFT enrollment process to a single, online process is an important next step in simplifying the administration of healthcare,” said Matthew G. Manders, President, Regional and Operations, Cigna Corporation. “CAQH’s new tool will make it easy for healthcare professionals to take advantage of the benefits EFT has to offer and will help Cigna comply with the ACA mandate.”

CAQH has a proven track record of developing innovative solutions that simplify healthcare administration through industry collaboration. The CAQH Universal Provider Datasource (UPD®) is used by over one million providers to share credentialing and other professional information with close to 700 health plans, hospitals and other related organizations. The CAQH Committee on Operating Rules for Information Exchange (CORE®) is a national industry multi-stakeholder initiative working to streamline electronic healthcare administrative data exchange and improve payer-provider interoperability. In 2012, CAQH CORE was designated by HHS to be the operating rule authoring entity for the EFT & electronic remittance advice (ERA) operating rules required in the ACA.

“The CAQH offering is unique in its ability for providers to enroll for EFT with multiple payers,” said Meg McCarthy, Executive Vice President of Innovation, Technology and Service Operations at Aetna. “By incorporating EFT enrollment with credentialing, it is an ideal way to increase adoption.”

To access the CAQH EFT enrollment tool, or for more information, please visit https://solutions.caqh.org.

About CAQH
CAQH serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers. CAQH solutions help promote quality interactions between plans, providers and other stakeholders; reduce costs and frustrations associated with healthcare administration; facilitate administrative healthcare information exchange; and encourage administrative and clinical data integration. Visit www.caqh.org for more information. Follow us on Twitter at @CAQH.

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