Which of these is the system by which payers deposit funds to the providers account electronically?

Enrolling in both ERA and EFT can help expedite the delivery of your payments from Cigna, make it easier to reconcile patient accounts, and much more.

What is an EFT?

Electronic Funds Transfer (EFT), also called direct deposit, transfers claim fee-for-service and capitated payments directly into your bank account. When you enroll in EFT, you can:

• Eliminate paper check mail delivery and handling.
• Access funds on the same day of the deposit.
• Increase efficiency and improve cash flow.
• View a separate remittance report online for each deposit, which shows the:
  • Deposit transaction
  • Details about the claims processed
  • Payments included in that fund transfer
• Easily reconcile payments using a single remittance tracking number:
  • Ask your bank to provide the payment related information from field 3 of record 7 on the EFT report they send to you
  • "Reference Identification Field" (or TRN02) on your ERA
  • Number located on the first page of your online remittance report

How Do I Enroll?

• Log in to CignaforHCP.com
• Select Working with Cigna
• Select Enroll in Electronic Funds Transfer (EFT) Options
• Complete the electronic enrollment form

Cigna then will send a "pre-note" transaction to your bank to verify all the banking information is correct. If the pre-note is:

• Not returned to Cigna: You will begin receiving EFT on your next payment cycle
• Returned to Cigna with errors: Cigna will contact you to obtain correct banking information

To check the status of your EFT application:

• Log in to CignaforHCP.com (if you have not registered yet you will need to do so)
• Select Working with Cigna
• Select Manage EFT Settings

For more details and vendor requirements, go to the CignaforHCP website.

What is an ERA?

Electronic Remittance Advice (ERA) provides a HIPAA-compliant detailed explanation of how Cigna processes claims from health care providers. ERA can be automatically loaded into your accounts receivable system. If you enroll in ERA, it can help you:

• Reduce costs and save time.
• Reduce posting errors.
• Shorten the payment cycle.

How Do I Enroll to Receive ERAs?

1. Notify your EDI vendor or Post-n-Track® that you would like to enroll for Cigna ERA.
2. Provide enrollment information as instructed by your EDI vendor or Post-n-Track (if you use more than one TIN, complete a separate enrollment for each TIN).
3. Your EDI vendor or Post-n-Track will send the completed enrollment information to Cigna for processing; Cigna will finalize your registration within 10 business days of receiving it.
4. You may begin receiving ERAs on your next payment cycle

For more details, visit CignaforHCP.

Glossary Chapter 4 accept assignment provider accepts as payment in full whatever is paid on the claim by the payer (except for any copayment and/or coinsurance amounts). accounts receivable the amount owed to a business for services or goods provided. accounts receivable aging report shows the status (by date) of outstanding claims from each payer, as well as payments due from patients. accounts receivable management assists providers in the collection of appropriate reimbursement for services rendered; includes functions such as insurance verification/eligibility and preauthorization of services. allowed charge the maximum amount the payer will reimburse for each procedure or service, according to the patient's policy. ANSI ASC X12 an electronic format standard that uses a variable-length file format to process transactions for institutional, professional, dental, and drug claims. appeal documented as a letter, signed by the provider, explaining why a claim should be reconsidered for payment. assignment of benefits the provider receives reimbursement directly from the payer. bad debt accounts receivable that cannot be collected by the provider or a collection agency. beneficiary the person eligible to receive health care benefits. birthday rule determines coverage by primary and secondary policies when each parent subscribes to a different health insurance plan. chargemaster document that contains a computer-generated list of procedures, services, and supplies with charges for each; chargemaster data are entered in the facility's patient accounting system, and charges are automatically posted to the patient's bill (UB-04). claims adjudication comparing a claim to payer edits and the patient's health plan benefits to verify that the required information is available to process the claim; the claim is not a duplicate; payer rules and procedures have been followed; and procedures performed or services provided are covered benefits. claims attachment medical report substantiating a medical condition. claims processing sorting claims upon submission to collect and verify information about the patient and provider. claims submission the transmission of claims data (electronically or manually) to payers or clearinghouses for processing. clean claim a correctly completed standardized claim (e.g., CMS-1500 claim). clearinghouse performs centralized claims processing for providers and health plans. closed claim claims for which all processing, including appeals, has been completed. coinsurance also called coinsurance payment; the percentage the patient pays for covered services after the deductible has been met and the copayment has been paid. common data file abstract of all recent claims filed on each patient. Consumer Credit Protection Act of 1968 was considered landmark legislation because it launched truth-in-lending disclosures that required creditors to communicate the cost of borrowing money in a common language so that consumers could figure out the charges, compare costs, and shop for the best credit deal. coordination of benefits (COB) provision in group health insurance policies that prevents multiple insurers from paying benefits covered by other policies; also specifies that coverage will be provided in a specific sequence when more than one policy covers the claim. covered entity private sector health plans (excluding certain small self-administered health plans), managed care organizations, ERISA-covered health benefit plans (Employee Retirement Income Security Act of 1974), and government health plans (including Medicare, Medicaid, Military Health System for active duty and civilian personnel; Veterans Health Administration, and Indian Health Service programs); all health care clearinghouses; and all health care providers that choose to submit or receive transactions electronically. day sheet also called manual daily accounts receivable journal; chronological summary of all transactions posted to individual patient ledgers/accounts on a specific day. deductible amount for which the patient is financially responsible before an insurance policy provides coverage. delinquent account one that has not been paid within a certain time frame (e.g., 120 days); also called delinquent account. delinquent claim claim usually more than 120 days past due; some practices establish time frames that are less than or more than 120 days past due. delinquent claim cycle advances through various aging periods (30 days, 60 days, 90 days, and so on), with practices typically focusing internal recovery efforts on older delinquent accounts (e.g., 120 days or more). downcoding assigning lower-level codes than documented in the record. electronic data interchange (EDI) computer-to-computer exchange of data between provider and payer. electronic flat file format series of fixed-length records (e.g., 25 spaces for patient's name) submitted to payers to bill for health care services. electronic funds transfer (EFT) system by which payers deposit funds to the provider's account electronically. Electronic Funds Transfer Act established the rights, liabilities, and responsibilities of participants in electronic funds transfer systems. Electronic Healthcare Network Accreditation Commission (EHNAC) organization that accredits clearinghouses. electronic media claim series of fixed-length records (e.g., 25 spaces for patient's name) submitted to payers to bill for health care services. electronic remittance advice (ERA) remittance advice that is submitted to the provider electronically and contains the same information as a paper-based remittance advice; providers receive the ERA more quickly. encounter form financial record source document used by providers and other personnel to record treated diagnoses and services rendered to the patient during the current encounter. Equal Credit Opportunity Act prohibits discrimination on the basis of race, color, religion, national origin, sex, marital status, age, receipt of public assistance, or good faith exercise of any rights under the Consumer Credit Protection Act. Fair Credit and Charge Card Disclosure Act amended the Truth in Lending Act, requiring credit and charge card issuers to provide certain disclosures in direct mail, telephone, and other applications and solicitations for open-end credit and charge accounts and under other circumstances; this law applies to providers that accept credit cards. Fair Credit Billing Act federal law passed in 1975 that helps consumers resolve billing issues with card issuers; protects important credit rights, including rights to dispute billing errors, unauthorized use of an account, and charges for unsatisfactory goods and services; cardholders cannot be held liable for more than $50 of fraudulent charges made to a credit card. Fair Credit Reporting Act protects information collected by consumer reporting agencies such as credit bureaus, medical information companies, and tenant screening services; organizations that provide information to consumer reporting agencies also have specific legal obligations, including the duty to investigate disputed information. Fair Debt Collection Practices Act (FDCPA) specifies what a collection source may and may not do when pursuing payment of past due accounts. guarantor person responsible for paying health care fees. litigation legal action to recover a debt; usually a last resort for a medical practice. manual daily accounts receivable journal also called the day sheet; a chronological summary of all transactions posted to individual patient ledgers/accounts on a specific day. noncovered benefit any procedure or service reported on a claim that is not included on the payer's master benefit list, resulting in denial of the claim; also called noncovered procedure or uncovered benefit. nonparticipating provider (nonPAR) does not contract with the insurance plan; patients who elect to receive care from nonPARs will incur higher out-of-pocket expenses. open claim submitted to the payer, but processing is not complete. out-of-pocket payment established by health insurance companies for a health insurance plan; usually has limits of $1,000 or $2,000; when the patient has reached the limit of an out-of-pocket payment (e.g., annual deductible) for the year, appropriate patient reimbursement to the provider is determined; not all health insurance plans include an out-of-pocket payment provision. outsource contract out. participating provider (PAR) contracts with a health insurance plan and accepts whatever the plan pays for procedures or services performed. past-due account one that has not been paid within a certain time frame (e.g., 120 days); also called delinquent account. patient account record also called patient ledger; a computerized permanent record of all financial transactions between the patient and the practice. patient ledger also called patient ledger; a computerized permanent record of all financial transactions between the patient and the practice. pre-existing condition any medical condition that was diagnosed and/or treated within a specified period of time immediately preceding the enrollee's effective date of coverage. primary insurance associated with how an insurance plan is billed?the insurance plan responsible for paying health care insurance claims first is considered primary. Provider Remittance Notice (PRN) remittance advice submitted by Medicare to providers that includes payment information about a claim. secondary insurance billed after primary insurance has paid contracted amount. source document the routing slip, charge slip, encounter form, or superbill from which the insurance claim was generated. superbill term used for an encounter form in the physician's office. suspense pending. Truth in Lending Act was considered landmark legislation because it launched truth-in-lending disclosures that required creditors to communicate the cost of borrowing money in a common language so that consumers could figure out the charges, compare costs, and shop for the best credit deal. two-party check check made out to both patient and provider. unassigned claim generated for providers who do not accept assignment; organized by year. unauthorized service services that are provided to a patient without proper authorization or that are not covered by a current authorization. unbundling submitting multiple CPT codes when one code should be submitted. value-added network (VAN) clearinghouse that involves value-added vendors, such as banks, in the processing of claims; using a VAN is more efficient and less expensive for providers than managing their own systems to send and receive transactions directly from numerous entities.

What does EFT mean in healthcare?

What is an EFT payment method?

What does EFT and ERA mean?

Which is remittance advice submitted by Medicare?