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‘Value-added’ fees, virtual credit cards can be rectified

Dentist recommends that colleagues contact their third-party directly to demand how they want to be reimbursed

May 27, 2020

By David Burger

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Editor’s note: This is the 32nd 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.

Electronic fund transfers should be free.

Per the Code of Federal Regulations, “a health plan may not charge fees or costs in excess of the fees or costs for normal telecommunications that the entity incurs.”

However, billing vendors often tack on a transaction fee for what is referred to as “value-added” services. Those services vary, but sometimes they include hotlines for dentists to call if they experience issues.

“There should be no charges for EFTs,” affirmed Dr. Sara Stuefen, a general dentist in Vinton, Iowa, who owns her practice and is a member of the ADA Council on Dental Benefit Programs. She said she has heard complaints from fellow dentists about these additional fees, and said dentists shouldn’t have to stand for it.

Dentists not wishing to incur the transaction fees are encouraged to ask the vendors if payments can be received without the “value-adds” and thus, free of charge, she said.

What bothers her even more is when third-party payers send dentists virtual credit cards as payment. The dental practice increases its operating costs by paying the merchant service fees to process payment, which can range from 2% to 5% depending on the dentist’s merchant service costs.

If a third-party payer offers to reimburse a dentist through a virtual credit card, Dr. Stuefen, who has been handling EFTs at her practice for nearly a decade, said, “Don’t be scared to tell a payer that you don’t want to receive virtual credit cards. Be proactive.”

Brad Smith, senior director of ACH Network Administration & Industry Verticals at Nacha, short for the National Automated Clearing House Association, agreed with Dr. Stuefen in that EFTs should be free of arbitrary fees for services not desired by dentists.

“Dental practices will have to ask the health plans and clearinghouses what those value-added services are,” Mr. Smith said. “EFT and electronic remittance advice are straightforward transactions mandated by the federal government. They aren’t value-added services.”

He also said that dentists shouldn’t have to accept virtual credit cards.

“In fact, many dentists that we’ve spoken to have opted out of receiving virtual credit cards for payment,” Mr. Smith said.

 Photo of Sara Stuefan
Dr. Stuefen

If a dentist believes that entities are unfairly charging for EFTs, Mr. Smith said, and refusing to pay through the no-cost version of the EFT transaction, dentists should consider lodging an official complaint directly with the Centers for Medicare & Medicaid Services.

“Some practices have reported that simply requesting the no-cost EFT option was enough,” Mr. Smith said.

Dr. Stuefen and Mr. Smith presented an ADA webinar called ACHing for EFT together in January that was recorded and is free for on-demand viewing for members on the ADA Center for Professional Success. The webinar focuses on how dentists can reduce practice overhead costs through use of electronic data interchange and how EFTs via automated clearinghouses (ACH) could reduce the manual time and effort — and costs — associated with receipt and processing paper checks.

“EFT means dentists get their hard-earned money quickly, safely and at a very low cost,” Mr. Smith said. “Claim payments go directly into a practice’s bank account. No waiting for checks to arrive; no trips to the bank; no waiting for checks to clear; no lost checks. Who wouldn’t like that?”

Payers also cannot recoup money through the EFT/ACH process without the dentist’s permission.

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.