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A few commenters indicated hospitals may lack direct access to EDI 835 ERA transaction data

The Part B deductible stands as the prime example of this disconnect-most Medigap plans available today do not cover it at all, according to Medicare.gov

However, we do offer insurance-pay options for certain prescriptions: While we assist with prior authorizations and prescription submissions, we do not bill insurance directly

Removal of these measures would alleviate the burden on hospitals, REHs, and ASCs to manually screen each patient and submit data each reporting cycle, allowing hospitals, REHs, and ASCs to focus resources on measurable clinical outcomes and direct patient care