The use of VCCs, which are designed to reduce the potential for fraud, can pose problems for healthcare providers, the organization says.
The Electronic Data Interchange Task Force warns that the use of virtual credit cards by healthcare payers to make payments to providers, while mitigating some fraud issues, can cause problems for providers who are out of a plan’s network or use other means to settle claims.
WEDI, an organization that addresses emerging health information technology issues related to information exchange, raised concerns in a recent commentary. letter (registration required) submitted to the Centers for Medicare & Medicaid Services.
CMS, which oversees the operations of federal health insurance programs, recently sought advice on two issues. A (GL-2022-04) covers the payment of health plan claims using virtual credit cards and has adopted HIPAA standards for electronic funds transfers and remittance advice transactions. The other (GL-2022-03) relates to the responsibility of HIPAA-covered entities to ensure that business associates comply with HIPAA.
Virtual credit cards, designed for one-time use, hide the actual card number. Card issuers typically provide software that helps a customer generate a temporary credit card number, linked to their permanent number, to enhance security and help prevent fraud.
In its comments, WEDI asks CMS for more clarification on specific topics surrounding virtual credit cards and electronic funds transfers. She asks CMS to provide information on the security of electronic payments compared to paper checks.
“VCC payments may not be more secure than EFT payments made through the ACH network (the ACH Automated National Clearinghouse for Electronic Funds Transfers), but this type of payment reduces credit card fraud” , notes WEDI.
Some providers are reluctant to adopt EFT payments “because they are not comfortable using portals (or other mechanisms) to reveal their banking information,” WEDI says. And more work needs to be done to ensure that certain standards created by ANSI X12 can work well with virtual credit card payments.
Electronic funds transfer and electronic remittance advice issues can also arise if an out-of-network provider does not complete a health plan’s EFT and ERA enrollment process. According to WEDI, CMS needs to provide more clarity on how out-of-network providers can receive electronic payments, particularly where registration for electronic payment processes has not been completed.
WEDI’s letter, which discusses these and other concerns with CMS on these guidance topics, can be found here.