Re “Doctors shouldn’t be overcharged for electronic payments”: I am writing to provide information and insights that were missing from your Aug. 26 editorial about electronic payments in the health care field.

It’s important to note that providers do have choices for receiving payments from health insurers. They can choose to be paid with a paper check or electronically, via virtual credit cards or electronic funds transfers. Based on differing needs and preferences, providers can choose to opt in and opt out of each of the payment methods at any time. Guidance from the Centers for Medicare and Medicaid Services makes clear that all providers can receive standard EFT payments without extra fees.

There is a misconception about value-added EFT services. Organizations like Zelis offer an opt-in, fee-based EFT service that allows providers to receive payments securely from hundreds of health insurers through one platform. Many providers and hospital systems find the reduced administrative burden and the additional automated reconciliation of claims with payments through this platform well worth the cost of participation.

An important clarification is warranted here in response to your reference to Zelis’s role in CMS’s removal of a notice from its website in 2018. CMS removed frequently asked questions that were being misinterpreted. CMS stated that while standard EFTs must be offered at low to no cost, CMS does not have the responsibility to regulate fees for optional value-added services.

Finally, we take exception to your assertion that innovations in electronic health care payments are costing the system money. In fact, these innovations are reducing costs by hundreds of millions of dollars each year by digitizing and reconciling payments, preventing fraudulent activity, and significantly reducing administrative burden. Greater innovation, investment, expertise, and collaboration are needed to address the thorny challenges that plague the broken health care system. We find it is more productive to work to align the key stakeholders in the system than to drive wedges that only serve to amplify disagreements and slow progress toward real solutions.

Yusuf Qasim

President of payments optimization




Source link