Electronic Funds Transfer (EFT)

Administrative Policy:
Electronic Funds Transfer (EFT)

Effective Date:
January 27, 2012

Last Revised Date:
March 02, 2018

Scope:
All participating physicians, other health care professionals, and ancillary entities (acute rehabilitation facility, ambulance, ambulatory surgical center, cardiac monitoring, dialysis center, durable medical equipment supplier, home health care agency, home infusion provider, hospice, laboratory, prosthetic/orthotic supplier, psychiatric/substance abuse facility, skilled nursing facility, sleep program, mobile diagnostics provider, wound care services, and sub-acute care facility) who participate in the Horizon Managed Care Network and/or Horizon PPO Network.

Purpose:
To establish Horizon BCBSNJ’s written policy requiring physicians, other health care professionals and ancillary entities to register for Electronic Funds Transfer (EFT).

Objectives:

• Reduce turnaround time for issuing reimbursement.
• Reduce paperwork and overall administrative costs.
• Reduce the opportunity for error/theft.
• Eliminate paper checks, vouchers, and explanation of payment (EOP) to track and deposit

Policy:
As of April 2012, Horizon BCBSNJ requires all participating physicians, other health care professionals and ancillary entities to register for EFT within 30 days of participation with the Horizon Managed Care Network and/or Horizon PPO Network. Participating physicians, other health care professionals and ancillary entities are also required to currently be registered with EFT.

Registration for EFT is completed through NaviNet for physicians and other health care professionals.

Ancillary entities register for EFT by completing the Horizon Blue Cross Blue Shield of New Jersey EFT Ancillary Form.

Once enrolled, Horizon BCBSNJ will perform two test deposits (under a dollar) into the indicated bank account. Confirmation of receipt of the test deposits must occur within 30 days to complete the EFT registration. EFT will begin 2 to 4 business days after confirmation of test deposits and paper vouchers will be discontinued following 30 days of EFT enrollment.

Horizon BCBSNJ maintains a Frequently Asked Questions document to provide answers to the most commonly asked EFT questions.

With respect to nonparticipating providers, they may enroll in EFT upon request.

Procedure:
Horizon BCBSNJ periodically monitors EFT registration to ensure compliance with the EFT requirement. Horizon BCBSNJ reserves the right to re-evaluate the participation status of providers who do not comply with this requirement.

References:

• Horizon Healthcare of New Jersey, Inc. Agreement with Participating Physicians and Other Healthcare Professionals- Managed Care Network
• Horizon Blue Cross Blue Shield of New Jersey Agreement with Participating Physicians and Healthcare Professionals- PPO Network
• Ancillary Provider Agreement

HCM-PP-HCS-005-0318