MGMA: Some Physicians “Getting Fleeced” When Receiving Electronic Paychecks | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

MGMA: Some Physicians “Getting Fleeced” When Receiving Electronic Paychecks

September 11, 2017
by Rajiv Leventhal
| Reprints

Nearly one in five doctors surveyed in a recent MGMA (Medical Group Management Association) Stat poll reported that their electronic funds transfer (EFT) payments from health plans come with a fee.

As explained by MGMA, typically, physician practices in the past would receive a paper check from a health plan for payment of a medical service. In 2012, the Centers for Medicare & Medicaid Services (CMS) established a standard for the electronic funds transfer and supporting operating rules.

But as Robert Tennant, director of health IT policy, MGMA, noted, “Some health plans and their contracted payment vendors have sought to take advantage of physician practices by forcing them to pay fees to receive their payments for medical services via EFT. These transaction fees typically range from 2 to 5 percent of the total medical services payment.”

According to MGMA’s September poll, 17 percent of respondents indicated that their EFT payments from health plans came with a fee, with 50 percent saying there was no fee attached to the transaction. More than 32 percent indicated that they were unsure. Of those who responded yes to receiving fees for EFT payments, almost 60 percent stated that these health plans use a third-party payment vendor. “Providers are forced to pay these EFT fees as CMS has yet to issue explicit guidance against health plans and payment vendors charging these tolls,” noted MGMA’s Tennant.

For practices, the most common savings are in the ability to automate the re-association of the electronic payment with the electronic remittance advice (ERA), as well as savings in staff time to process and deposit paper checks manually.

“Even though health plans save money not printing and mailing paper checks, some bad actors are fleecing physician groups by charging them to simply receive an electronic paycheck,” Anders Gilberg, MGMA senior vice president, government affairs, said in a statement. “It is critical that CMS issue long-overdue guidance explicitly prohibiting this practice.”

MGMA said that it has been, along with other provider organizations, advocating that CMS release regulatory guidance relating to EFT operating rules. “Once that guidance is in place and physician practices are no longer subject to unreasonable fees, we believe provider adoption of the EFT transaction will increase,” officials said.

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Healthcare Execs Anticipate High Cost Returns from Predictive Analytics Use

Healthcare executives are dedicating budget to predictive analytics, and are forecasting significant cost savings in return, according to new research from the Illinois-based Society of Actuaries.

Adam Boehler Tapped by Azar to Serve as Senior Value-Based Care Advisor

Adam Boehler, currently director of CMMI, has also been named the senior advisor for value-based transformation and innovation, HHS Secretary Alex Azar announced.

Vivli Launches Clinical Research Data-Sharing Platform

On July 19 a new global data-sharing and analytics platform called Vivli was unveiled. The nonprofit group’s mission is to promote, coordinate and facilitate scientific sharing and reuse of clinical research data.

Survey: More Effective IT Needed to Improve Patient Safety

In a Health Catalyst survey, physicians, nurses and healthcare executives said ineffective information technology, and the lack of real-time warnings for possible harm events, are key obstacles to achieving their organizations' patient safety goals.

Physicians Still Reluctant to Embrace Virtual Tech, Survey Finds

While consumers and physicians agree that virtual healthcare holds great promise for transforming care delivery, physicians still remain reluctant to embrace the technologies, according to a new Deloitte Center for Health Solutions survey.

Geisinger, AstraZeneca Partner on Asthma App Suite

Geisinger has partnered with pharmaceutical company AstraZeneca to create a suite of products that integrate into the electronic health record and engage asthma patients and their providers in co-managing the disease.