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Episode 162: Workgroup Voices, The Inner Workings of Prior Authorization

August 23, 2016

The opportunities for improved efficiency and cost-savings associated with industry adoption of the Automated Clearing House (ACH) Electronic Funds Transfer (EFT) transaction are well established. However, despite having a national standard and supporting operating rules, ACH EFT is significantly underutilized by the industry, with the most recent CAQH Index® reporting that only 61.4% of claims payment are made via ACH EFT.1 The purpose of this principles document is to establish a consensus- driven set of principles that each impacted stakeholder2 could review and adopt in an effort to drive adoption of ACH EFT while at the same time establishing guidelines for the use of alternative payment options.

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