AHA urges CMS to use existing claims processing framework for advanced explanation of benefits

The Centers for Medicare & Medicaid Services should require health insurers to use the existing claims processing framework to create a patient’s advanced explanation of benefits to ensure the AEOB closely reflects the patient’s final bill and cost information, the AHA told the agency today.
 
Responding to a CMS request for information regarding AEOBs and Good Faith Estimates for covered individuals, AHA said it “appreciates CMS efforts to promote greater price transparency and give patients a reasonable expectation of their costs of planned treatment through the issuance of an AEOB to patients prior to care delivery” and “that CMS has delayed enforcement of these provisions until a standard industry process for such information exchange can be adopted via regulation to ensure that these estimates can be created as efficiently and accurately as possible.”