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electronic funds transfer

eft
finance·Updated Jun 13, 2026

Definition

ISO-11179 Definition

The electronic transmission of healthcare claim payment funds directly from a health insurance payer bank account to a provider bank account, replacing paper check payments and enabling faster, more accurate cash management. The HIPAA Administrative Simplification provisions require payers to offer electronic funds transfer to providers upon request using the CCD+ format. Electronic funds transfer is paired with the HIPAA 835 electronic remittance advice transaction to provide both the payment and the detailed explanation of how each claim was processed in a standardized electronic format.

Healthcare organizations that adopt EFT and ERA eliminate check handling costs, reduce payment posting errors, and accelerate cash availability. Healthcare data teams track EFT adoption rates by payer, measure the cost reduction from eliminating paper check processing, and reconcile EFT deposits against 835 remittance data to ensure all expected payments are received and accurately posted.

Standard Abbreviation

eft

Category

finance

Production DDL — FACT_CLAIM_TRANSACTION

FACT_CLAIM_TRANSACTION.sql
CREATE OR REPLACE TABLE FACT_CLAIM_TRANSACTION (
    clm_txn_key     INTEGER        NOT NULL  -- surrogate key,
    clm_id          VARCHAR(50)    NOT NULL  -- claim identifier,
    mbr_key         INTEGER        NOT NULL  -- FK to DIM_MEMBER,
    prvdr_key       INTEGER        NOT NULL  -- FK to DIM_PROVIDER,
    clm_typ_cd      VARCHAR(10)              -- claim type code,
    tot_chrg_amt    DECIMAL(18,2)            -- total charged amount,
    tot_alwd_amt    DECIMAL(18,2)            -- total allowed amount,
    tot_pd_amt      DECIMAL(18,2)            -- total paid amount,
    cntrct_adj_amt  DECIMAL(18,2)            -- contractual adjustment,
    denial_ind      CHAR(1)                  -- denial indicator,
    denial_rsn_cd   VARCHAR(10)              -- denial reason code,
    prior_auth_nbr  VARCHAR(30)              -- authorization number,
    clm_lag_days    SMALLINT                 -- claim lag days,
    days_ar         SMALLINT                 -- days in AR,
    load_dt         TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical finance table. Convert to BigQuery or Databricks →

Why This Term Matters

Healthcare data terminology is foundational for any data engineer working in this industry. Precise understanding of standard terms enables accurate schema design, reduces downstream data quality issues, and ensures pipelines meet the regulatory and interoperability requirements imposed by HIPAA, HL7 FHIR, and CMS reporting frameworks. Without this foundation, even technically well-built pipelines produce data that fails validation when it reaches payers or regulators.

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