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Dentists can opt out of credit card reimbursement from third-party payers

October 31, 2018

By David Burger

Editor's note: This is the 20th story in the Decoding Dental Benefits series featuring answers and solutions for dentists when it comes to the world of dental benefits and plans. The series is intended to help untangle many of the issues that can potentially befuddle dentists and their teams so that they can focus on patient care.

Just because you're an ADA trustee doesn't mean you are free from dental benefit headaches.

Photo of Dr. Fisch
Dr. Fisch
Dr. Judith Fisch, 1st District trustee, had no fewer than three third-party payers reimburse her for services rendered with stored-value credit cards, rather than her preferred method of traditional paper checks or electronic funds transfer.

What galled her was that she had never authorized the payers to use that method of reimbursement nor did they notify her office that they would be sending a payment in that manner and to opt out if they were not interested.

"This is an unfortunate tactic on their part that creates more work for the dental office, and yet if you don't do that work, you will most likely also incur credit card transaction fees," said Dr. Fisch, who runs a general practice with her husband, also a dentist, in Vermont. "It really isn't right to reimburse the dentist with a virtual credit card if the dentist did not opt in to receiving payment in this manner."

So she did what all member dentists can do: Call the ADA.

Dr. Fisch talked with staff from the Center for Dental Benefits, Coding and Quality and explained her predicament. They, in turn, contacted the carrier and related Dr. Fisch's concerns. Staff was able to procure a hard-to-find number in which she could call to opt out of receiving credit card payments.

"The staff at the ADA was amazing," Dr. Fisch said. "They were very helpful."

Truth is, it is not uncommon today for dental benefit carriers and third- party administrators to pay dental offices with a credit or debit card instead of the traditional paper check, said Dr. Christopher Bulnes, chair of the ADA Council on Dental Benefit Programs. In fact, this trend seems to be more popular with third-party administrators than it is with traditional dental plan carriers and has created concerns for dental offices, he said.

According to Dr. Bulnes, the bottom line is that dentists do not have to accept the stored-value card as payment if they do not wish to do so.

They can request to opt out of using the stored-value card and instead receive a check, he said. If that is their choice, dentists should call the number provided on the explanation of benefits statement, which accompanies the stored-value card, and inform them that a check is preferred and that they are not interested in utilizing the stored-value card for claim payments.  In Dr. Fisch's case, the companies chose to reimburse in this way without informing the recipient so the choice to opt out occurs after the fact, which results in waiting longer for a new means of payment.

DDB LogoDr. Bulnes said that the ADA has received reports from some dentists indicating that some of these companies' customer service representatives are reluctant to waive the stored-value card as payment; thus, dentists may have to escalate their request to a supervisor or manager with the company.

The ADA has created an online landing page for dental benefits information that can help dentists address and resolve even their most vexing questions. Go to ADA.org/dentalbenefits, part of the ADA Center for Professional Success.

A video on credit card payments is available there at ADA.org/creditcard.

The ADA has created an online landing page for dental benefits information that can help dentists address and resolve even their most vexing questions. Go to ADA.org/dentalbenefits, part of the ADA Center for Professional Success.

Staff from the Center for Dental Benefits, Coding and Quality can help dentists with dental benefits-related and coding problems, questions and concerns. Call the ADA's Third Party Payer Concierge at 1-800-621-8099 or email dentalbenefits@ada.org.

Previous installments in the Decoding Dental Benefits series are available at ADA.org/decoding.