Janet Estep is president and CEO of NACHA – The Electronic Payments Association, a not-for-profit trade association that oversees the Automated Clearing House (ACH) Network, one of the largest electronic payments networks in the world. Estep recently took time from here schedule to discuss how NACHA can support the healthcare industry’s efforts to create an effective electronic claims and payment system.
What are areas where you see NACHA helping the healthcare industry develop electronic payment methods for healthcare claims?
One of the key objectives of healthcare administrative simplification is to reduce the cost of healthcare by infusing efficiency into administrative transactions. This will require collaboration and cooperation amongst all participants. NACHA will focus upon its core competencies of rule-making, collaboration, and education to help bring entities together. As we have been providing operating rules to the financial services industry for over thirty-five years, we hope that skill set can also assist the healthcare industry as it implements operating rules for administrative transactions – including EFT and ERA transactions which directly impact financial institutions and their healthcare customers. We know that the HIPAA 835 healthcare claim payment/remittance advice can be carried as addenda data to a NACHA payment record today, and we will be working with the industry to ensure it can be supportive of healthcare payments into the future.
How can NACHA's rule-making process help move electronic claims processing forward?
One of the attributes of the NACHA rule-making process is that it is inclusive of entities of many different types. We have developed mechanisms to represent thousands of financial institutions so that all voices are heard. What is remarkable is the resilience the NACHA Operating Rules have shown over time – being adopted and then implemented by literally thousands of entities at the same time in order to provide for a truly interoperable network. It is intriguing to envision a future healthcare industry where operating rules are adopted in a consistent fashion by all – providing for true interoperability and certainty of transactions.
How aggressively are banks making the internal investments needed to be able to service the healthcare industry?
Many financial institutions have been working very closely with their healthcare industry customers over the years, and have made continual investments to provide a consistently high level of support. NACHA will continue to work with others in the industry to ensure that all financial institutions understand both their obligations and the opportunities as they support healthcare transactions. The benefits of passing payments with information, electronically, is one that financial institutions both understand and support in a variety of ways today, and they also recognize how this capability will provide true value to participants seeking greater efficiencies in healthcare payment practices.