Questions Submitted by the Public, by Date Posted to the Website. Electronic funds transfer vs. checks


Under HIPAA, are health plans required to pay health care claims via electronic funds transfer or may they pay by check?


The implementation specification for the health care claims remittance advice (X12N 835) contains two parts, a mechanism for the transfer of dollars and one for the transfer of information about the claim payment. These two parts may be transmitted separately.

The X12N 835 implementation specification allows payment to be sent in a number of different, acceptable ways, including by check and electronic funds transfer. You must be able to send the remittance advice portion of the X12N 835 electronically, but you may continue to send payment via check.