As a dental professional, getting paid promptly and fully for the services you provide is critical to maintaining a healthy practice. But more and more dentists are discovering that insurance plans are shifting to virtual credit card (VCC) payments—a method that comes with merchant fees that cut into your bottom line.

If you’re frustrated by this, you’re not alone. Even worse, insurance plans often claim that you have no choice but to accept these costly payment methods. Let’s set the record straight on your rights and what you can do to stop it.

What Are Virtual Credit Cards (VCCs), and Why Are They a Problem?

Virtual credit cards are single-use card numbers issued by insurers that allow providers to receive payment electronically. Sounds convenient, right? Unfortunately, there’s a catch: you, the provider, are responsible for the processing fees, which can range from 2% to 5% of the payment.

Let’s say you’re paid $1,000 for a procedure. With a 3% fee, that’s $30 lost, simply for receiving your payment.

Multiply that over hundreds of claims and you can see how this starts to bleed your practice financially.

Is It Legal for Insurers to Force VCCs on You?

No, it’s not.

According to federal regulations, insurers must offer you a no-fee alternative for electronic payments, such as ACH (Automated Clearing House) direct deposits.

Here’s what you need to know:

• The Centers for Medicare & Medicaid Services (CMS) clarified in 2018 that health plans cannot require providers to accept virtual credit cards.

• Under the HIPAA Administrative Simplification Rules, providers have the right to request payment via standard electronic funds transfer (EFT) through the ACH network.

• Health plans cannot charge you a fee or force you into a payment method that results in fees without your consent.

The Department of Health and Human Services (HHS) has echoed this guidance, stating that insurers must inform providers of their rights to no-fee ACH payments.

What Can You Do to Stop VCC Payments?

If you’re currently receiving VCC payments and want them to stop, here’s a step-by-step guide:

1. Contact the Payer Directly

Reach out to the insurance plan and request that they stop sending virtual credit card payments. Instead, ask to be enrolled in ACH/EFT payments through the standard NACHA network.

2. Submit a Formal EFT Request

Use the standardized EFT enrollment form developed by the Council for Affordable Quality Healthcare (CAQH) or one provided by the payer. Be sure to note that you do not consent to VCC payments and explicitly request ACH.

3. Cite Federal Guidance

If the payer resists, cite CMS and HHS regulations. Inform them that federal law entitles you to a no-fee electronic payment option and that forcing you to accept VCCs may be non-compliant.

Here’s language you can use:

"Per CMS guidance and HIPAA Administrative Simplification Rules, I have the right to receive electronic payments through the ACH network without incurring fees. Please update my payment preference to ACH/EFT immediately and cease all future virtual credit card payments."

4. File a Complaint if Necessary

If the payer refuses to comply, you can file a complaint with the Centers for Medicare & Medicaid Services (CMS) or the Office for Civil Rights (OCR) under HHS.

Consider Enlisting Help

You don’t have to fight this battle alone. Consider working with:

• Your dental association (e.g., ADA), which may have resources or legal guidance.

• A healthcare attorney familiar with provider payment rights.

• A practice management consultant who can help streamline payment processing and reduce administrative headaches.

Final Thoughts

Being forced to accept virtual credit cards is not only financially damaging—it’s also legally questionable. You have the right to control how you get paid, and that includes refusing payment methods that eat into your revenue.

Start by asserting your rights, pushing back with the right language, and demanding ACH/EFT as your standard. It’s your practice, your payment—and your right.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com