What is Electronic Funds Transfer (EFT) and how does it work?
EFT is a safe, proven, confidential method of receiving claim payment from Blue Cross and Blue Shield of New Mexico. Funds are electronically transferred directly into your bank account.
Is EFT for everyone?
EFT is an important benefit for any office or facility. As long as you have a bank account EFT can be an excellent financial planning tool as well as a safe, private, convenient way to receive payment for your claims.
I am uneasy about technology as it applies to electronic payments. Don't I have more control over finances by receiving a paper check?
Offices and facilities that receive their claim payments electronically are very satisfied with EFT. They feel that it is safer and more secure than receiving paper checks. EFT helps to eliminate lost or stolen checks. It prevents the possibility of checks being sent to an incorrect address. Problems with EFT are rare. It would be more likely to have problems with paper checks than electronically transferred funds.
How long does it take for the transfer of electronic funds?
With EFT Blue Cross and Blue Shield claim payments are deposited directly into your bank account within 72 hours after the claim has finalized. Funds come in as cash so there is no time wasted having the checks clear; the money earns interest right away.
The following schedule should be used as a guideline to determine when funds are available at your bank.
| Claims Processed | Bank Transfer | *Funds Available |
| Monday | Tuesday | Thursday |
| Tuesday | Wednesday | Friday |
| Wednesday | Thursday | Monday |
| Thursday | Friday | Tuesday |
| Friday | Monday | Wednesday |
| *Add one day if the normal banking day falls on a banking holiday. | ||
How do I get started?
It is very easy... just access the HCSC Electronic Funds Transfer Agreement and HCSC Electronic Funds Transfer Agreement Instructions. After completing and signing the Electronic Funds Transfer Rider send to:
Health Care Service Corporation
Electronic Commerce Services Unit - 25th Floor
300 East Randolph Street
Chicago, Illinois, 60601
Natural partners to EFT are Electronic Remittance Advice (ERA) and Electronic Payment Summary (EPS).
What is an Electronic Remittance Advice (ERA)?
An Electronic Remittance Advice explains benefit payment for Blue Cross and Blue Shield. An ERA shows which claims are paid and processed. This data in the HIPAA compliant format can then be posted to your accounts electronically. ERA eliminates the need for manual posting. The advantage is that the payment information is received in your office the day after the claims have been finalized.
Do I need specific software to receive an ERA?
The ERA is based on a provider's payment cycle and then delivered to an electronic mailbox. To access the mailbox, a single analog telephone line, asynchronous modem and communications software is needed. FTP Internet is also available. If you currently have a Submitter ID for Electronic Media Claims, (EMC), you may utilize the same Submitter ID to retrieve the ERA. Providers whose software is ERA capable can transfer an ERA to their computer. Some software offers a print option to allow you to print the Remittance Advice for review. You or your billing service will need translation programming to read the ERA. It is generated in the ANSI X12 835 format. Contact your software vendor for the availability of automatic posting software or programs.
What is an Electronic Payment Summary (EPS)?
The EPS is an electronic print image of the Provider Claim Summary (PCS). The EPS provides the same payment information you currently receive on your paper PCS. The advantage is that the payment information is received in your office the same day your ERA is delivered, the day after the claims have been finalized. The EPS can be used as a tool to assist you in the test process for your ERA automatic posting program.
What type of software do I need to receive the EPS?
The EPS is available the same way as the ERA is available. If your billing agent cannot accept the EPS, you can opt to have the EPS delivered to your own provider mailbox.
No special programming is required to receive the EPS. The EPS is only available in conjunction with the ERA.
How do I get started with ERA and EPS?
It is very easy... just access the Electronic Remittance Advice Form. Complete two forms if the EPS is requested to be delivered differently than the ERA.
If you have additional questions, please call the Electronic Commerce (eCommerce) Center at (800)746-4614.
