ACH the ‘Most Preferred Method’ for Healthcare Claim Payments
Every day across the U.S., lots of healthcare professionals receive lots of insurance payments, and new Nacha research shows there’s one common thread.
“Nobody likes checks. That’s what we heard. As a payment mechanism, they’re the least efficient, most manual,” said Bryan Chamberlin, a partner at Guidehouse.
Guidehouse recently studied the opportunities to expand ACH payments in the healthcare industry and the challenges posed. They met with 17 stakeholders in the healthcare payments space, including large healthcare systems, financial institutions, third-party vendors, and national/regional payers. Guidehouse discussed the findings in a June 17 webinar.
“Providers don’t want to process checks. They’ll do it for patients where they need to, but they certainly don’t want to do it on the volume and the scale of their insurance partners. And at the insurance companies, they don’t want to cut checks,” said Chamberlin, noting that the insurers they talked to were displeased with the associated costs.
“ACH is by far the most common, most preferred method,” said Chamberlin. In fact, the providers interviewed “told us that they really wanted all of their payors and all of their payments to be ACH. They acknowledged that it makes it fast, seamless and they have the ability to automate the process.” In contrast, Chamberlin said, “Where payments are not ACH, there is a reconciliation challenge, there could be manual processing.”
Nacha reported there were 510 million ACH healthcare claim payments in 2024, a number that has been consistently rising for years. Still, there’s room for improvement, particularly among dentists, which tend to be smaller operators.
Chamberlin said dentists “just don’t want to provide” information such as bank account numbers. Dentists also cited enrollment challenges with inconsistent requirements among the multiple insurers, plus concerns about insurers pulling back payments.
So how can the holdouts be won over? Guidehouse heard a lot about streamlining procedures ranging from the enrollment process to the way remittance advice is made available. Smoothing any bumps in the road will be a top focus for the new Healthcare Payments Advisory Group which Nacha is convening.
“We think it’s a perfect time to create this advisory group,” said Brad Smith, Nacha Senior Director, Industry Engagement and Advocacy. “We want to collaborate with industry stakeholders. We want to generate discussions about EFT/ACH not only for claim payment … but for B2B,” said Smith.
Nacha is looking for representatives from across a broad spectrum, including financial institutions, healthcare payment vendors, providers, and others. “The more diverse this group is, the better the discussions we’re going to have,” said Smith. The panel will meet virtually two to three times a year.
“We want to elevate ACH in the healthcare space,” said Smith. “When we look at ACH compared to other payment types—especially checks—we see that ACH is much lower cost. And any time we can lower costs in the healthcare space, the better off we’re going to be.”
Learn more about the Healthcare Payments Advisory Group on Nacha’s website.
