Recent studies by MGMA show that many practices are paying EFT fees they did not agree to, raising medical billing and payment costs. Furthermore, this egregious practice has doubled during the past year! 

In an August 2021 survey, MGMA asked practice leaders, 

• “Are insurers charging your practice fees you didn’t agree to when sending payments via EFT?” 
  • More than half (57%) responded “yes,” while 43% responded “no.”

A similar survey a year ago showed only 26% of groups paying fees to receive EFT reimbursement from payers.

MGMA believes this problem raises medical billing and payment costs and results from CMS action in 2017 that removed definitive guidance preventing health plans and payment vendors from charging these fees. 

MGMA’s position in a member Toolkit entitled Tips on Automating your Revenue Cycle and Avoiding EFT Fees is that health plan policies requiring network providers to contract with vendors who charge percentage-based fees to process the EFT/ERA transaction are inappropriate.

 “While it is within the right of any payment vendor to offer “value-added” services, these should be optional and the practice given the choice of receiving the EFT without any fees. Health plans or their contracted payment vendors should not require providers to incur such fees as the only method to receive EFT payments.”

MGMA is now pushing CMS to reinstate guidance that was in place in 2017 saying that only the provider’s financial institution may impose a fee to process EFT payments through the Automated Clearinghouse (ACH) Network. The guidance went on to specify that providers are not required to contract with payment vendors for “value-added services.”

• Since payers frequently send payments through a designated payment vendor, providers often don’t have a choice. MGMA believes this has led to the explosion in EFT fees.