Electronic Payments & Statements

Transcription

1 Electronic Payments & Statements

2 Topics What are Electronic Payments & Statements (EPS)? Common Terminology How You Save With Electronic Remittance Advice/Electronic Funds Transfer (ERA/and EFT) Automated Clearing House (ACH) Deposit Virtual Card Payments Remittance Advice Options Enroll in EPS More Information

3 What is EPS? Electronic Payments & Statements (EPS) is a payment system that has electronic funds transfer (EFT) and electronic remittance advice (ERA) for care providers. Care providers may sign up for EPS to receive direct deposit or virtual card payments plus ERAs or online remittance advice for the care they provide to UnitedHealthcare members. EPS is administered by Optum, which specializes in providing health care financial information, tools and solutions. EPS Electronic Payments EFT: Direct Deposit or Virtual Card Payment + Electronic Statements ERA File or Online Remittance Advice 3

4 Common Terminology Automated Clearing House (ACH) is an EFT system that makes payments by direct deposit. Electronic Funds Transfer (EFT) is an electronic payment by direct depositor Automated Clearing House (ACH). Electronic Remittance Advice (ERAL) are electronic data interchange (EDI) files that can be used to auto-post payments in a practice management system. The files can be downloaded from the EPS website or delivered by a clearinghouse. Care providers who post payments manually do not need to use EDI files. 4

5 Common Terminology (Cont.) Provider Remittance Advice (PRA) is a statement that shows o What insurance paid and what amount the member may owe. o Sometimes an Explanation of Benefits (EOB) is used instead of a PRA. Virtual Card Payments are electronic payments using credit card-based technology that doesn t require a care provider s bank account information. 5

6 How You Can Save With ERA and EFT The 2017 CAQH Index shows the average cost for manual transactions is consistently higher than electronic transactions for care providers and health plans. CAQH, a nonprofit alliance, creates the CAQH Index and is the leader in creating shared initiatives to streamline the business of health care. View the complete CAQH Index for more details. Samples of reported industry-wide savings for care providers: Just over $3.60 per claims status inquiry and remittance advice transaction* $1.63 electronic cost vs. $5.26 manual cost of a claims status inquiry* $1.13 electronic cost vs. $4.82 manual cost of a remittance advice transaction* *See pages for paper vs EFT costs in 2017 CAQH Index report 6

7 ACH Direct Deposit Here s how to enroll in ACH direct deposit and other information you ll need: 1. Enroll in EPS and select ACH direct deposit. 2. Receive notifications when payments are deposited /ERA are available the same day for auto-posting or save, view or print remittance advice and post payments manually from Optum s EPS website. What to Know: You get payments and remittances five to seven days faster than with paper. There are no credit card processing fees. There s a reduced risk of lost, misrouted and stolen checks. You can potentially eliminate bank lock box fees. Money is deposited directly into the accounts you designate. You can separate payments and remittances by national provider identifier (NPI) number and/or payer. 7

8 Virtual Card Payments Here s how to enroll in Virtual Card Payments and other information you ll need: 1. Enroll in EPS and select Virtual Card Payments. You ll receive card numbers in the mail with activation instructions. You ll get future payment notices delivered by Redeem payment using the standard card not present transaction /ERA are available the same day for auto-posting or view or print remittance advice and post payments manually from Optum s EPS website. What to Know Like an ACH deposit, you get payments and remittances five to seven days faster than with paper. There s a reduced risk of lost, misrouted and stolen checks. You can potentially eliminate bank lock box fees. 8

9 Virtual Card Payments (Cont.) What to Know You ll need to confirm with your merchant processor whether credit card processing fees apply. You ll receive a separate card number for each UnitedHealthcare plan for which you receive payments. 9

10 Remittance Advice Options Electronic provider remittance advice (EPRA) is the most popular for manual posting. EPRA is a PDF file containing all remittance information associated with a payment. It s consolidated to include multiple claims per page. You can also use the PDF for remittance advice for a single claim if you need to print it for a secondary carrier. EPRA are available the same day as the deposit is made. 10

11 EPRA Sample PDF 11

12 835/ERA for Auto-Posting 835/ERA are standardized computer files of remittance advice that can be auto-posted. You need a practice management system and a program that reads the 835/ERA such as Medicare Remit Easy Print (MREP) software. Files are available the same day as the deposit. You can get ERA files: o o Online at no cost using the EPS website Delivered through your clearinghouse 12

13 ERA Sample Computer File 13

14 Enroll in EPS You can access EPS in two ways: 1. Sign in to Link and access the EPS tool on your Link dashboard. 2. Go to Optum.com/EPS. 14

15 More Information To learn more about EPS, you can register for a webcast training session. Click here and then use the dropdown menu to select a session date and register. If you have questions, please call the EPS Help Desk at Choose "option 1" for enrollment and "option 2" if you have access questions. 15

16 Thank you. Insurance coverage provided by or through UnitedHealthcare Insurance Company, All Savers Insurance Company, Oxford Health Insurance, Inc. or their affiliates. Health Plan coverage provided by UnitedHealthcare of Arizona, Inc., UHC of California DBA UnitedHealthcare of California, UnitedHealthcare Benefits Plan of California, UnitedHealthcare of Colorado, Inc., UnitedHealthcare of Oklahoma, Inc., UnitedHealthcare of Oregon, Inc., UnitedHealthcare of Texas, LLC, UnitedHealthcare Benefits of Texas, Inc., UnitedHealthcare of Utah, Inc. and UnitedHealthcare of Washington, Inc., Oxford Health Plans (NJ), Inc. and Oxford Health Plans (CT), Inc. or other affiliates. Administrative services provided by United HealthCare Services, Inc., OptumRx, OptumHealth Care Solutions, LLC, Oxford Health Plans LLC or their affiliates. Behavioral health products are provided by U.S. Behavioral Health Plan, California (USBHPC), United Behavioral Health (UBH) or its affiliates United HealthCare Services, Inc.