Electronic Healthcare Claim Payments Surge in 2021

Healthcare ACH

HERNDON, Va., May 26, 2021 – As the COVID-19 pandemic begins to subside, healthcare claim payments are on the rise. 

Figures from Nacha, which governs the ACH Network, show nearly 37.4 million healthcare claim payments were made to providers by ACH in March 2021, the most ever in a single month, and an increase of 19.3% over March 2020. The value of those payments, more than $171.3 billion, is up 13% from a year earlier. 

From January through April of this year, the number of healthcare claim payments made electronically by ACH reached 132 million, an increase of 15.6%, and moved $622 billion.

“More medical and dental providers every year see the value of having insurance claims paid electronically,” said Michael Herd, Nacha Senior Vice President, ACH Network Administration. “While the pandemic made handling paper checks more difficult, providers appreciated seeing payments made safely and quickly by ACH Direct Deposit.”

The latest Nacha figures follow the February release of the 2020 CAQH Index, which found that electronic payment volume for the medical and dental industries increased 12% from the previous report.

By switching from manual payments to electronic payments by ACH, the medical industry could save $426 million while the dental industry could save $472 million. Each manual payment costs providers approximately $2 more than an electronic payment. 

“This data from Nacha is good news for payers, providers and members,” said April Todd, Senior Vice President, CORE and Explorations at CAQH. “The increase in electronic payment volume likely indicates that people who deferred routine medical appointments due to COVID are now able to get the care they need.  And when that care is paid electronically, it is more efficient and cost-effective for the industry.” 

The Patient Protection and Affordable Care Act (ACA) mandated identification of a healthcare EFT standard and the implementation of operating rules for all electronic healthcare transactions. Nacha and the healthcare industry worked together to create the Healthcare Electronic Funds Transfer (EFT) standard, which, since 2014, has supported HIPAA-compliant transactions between health plans and providers. Required information travels with the payment on the ACH Network, simplifying accounting procedures and reducing administrative costs. The CAQH CORE EFT & ERA Operating Rules, developed in collaboration with the healthcare industry and Nacha, support the seamless exchange and reassociation of electronic healthcare payment and remittance information.  

To learn more about benefits dentists achieve by routinely using ACH to receive payments visit Nacha’s website.

About Nacha
Nacha governs the thriving ACH Network, the payment system that drives safe, smart, and fast Direct Deposits and Direct Payments with the capability to reach all U.S. bank and credit union accounts. Nearly 27 billion ACH Network payments were made in 2020, valued at close to $62 trillion. Through problem-solving and consensus-building among diverse payment industry stakeholders, Nacha advances innovation and interoperability in the payments system. Nacha develops rules and standards, provides industry solutions, and delivers education, accreditation, and advisory services.

About CAQH
For more than 20 years, CAQH has helped nearly 1,000 health plans, 1.6 million providers, government entities and vendors connect, exchange information and operate more efficiently. CAQH technology-enabled solutions and its Committee on Operating Rules for Information Exchange (CORE) bring the healthcare industry together to make sharing business information more automated, predictable and consistent. CAQH Explorations researches opportunities to reduce the burden of manual processes in healthcare administration. Visit www.caqh.org and follow us on Twitter: @caqh.

Contact: Media Relations