IMPORTANT CHANGES EFFECTIVE OCTOBER 11, 2013: ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT

This message informs Trading Partners of changes being implemented to meet the Patient Protection and Affordable Care Act (PPACA) January 1, 2014 operating rule mandate. Trading Partners will experience these changes beginning October 11, 2013.

In a final rule published August 10, 2012, HHS requires that health plans follow specified Phase III CAQH Committee on Operating Rules for Information Exchange (CORE) EFT & ERA Operating Rules. Trading Partners will notice changes related to the "ERA Enrollment Data Rule." Trading Partners may find more information on the rules by accessing the CAQH Operating Rules Mandate - EFT and ERA website at: http://www.caqh.org/ORMandate_EFT.php.

The goals of the CORE is to enhance interoperability between providers and payers, streamline eligibility, benefits, and claims data transactions, and reduce the amount of time and resources providers spend on administrative function. The CAQH CORE Guiding Principles require that the CAQH CORE Operating Rules align with current standards, code sets, and other federal initiatives.

What does this mean to Trading Partners?

Effective October 11, 2013, there will be a new ERA Enrollment form published on the Trading Partner Business Center. Providers are NOT required to re-enroll or modify any of their ERA information as a result of this rule.

Timeframe

The changes described in this message will be effective October 11, 2013.