ADA calls out Aetna for limiting payment options for out-of-network dentists
Association fights to preserve payment choice
Aetna has announced it will discontinue issuing paper checks to out-of-network dentists, a tactic that makes it difficult for providers to receive their choice of payment unless they join its network.
The American Dental Association has urged Aetna to reconsider this change because it may be in conflict with payment choice statutes in several states. Aetna has not yet responded to the ADA’s request.
In the meantime, the Association encourages members with concerns to reach out to Aetna and their state insurance commissioner and review state laws that may protect payment choice for out-of-network dentists. The ADA is collaborating with state dental associations to address this issue.
The ADA previously voiced strong opposition to actions by Delta Dental of California to charge a weekly $15 fee as a separate administrative charge to dentists who want to be paid by paper checks. In addition to a letter the ADA sent July 8 to the National Association of Insurance Commissioners against this payment policy shift, the ADA Council on Dental Benefit Programs compiled a Q&A to assist dentists if they wish to move from paper checks to electronic funds transfer, or EFT.
The Q&A addresses the hidden costs associated with certain forms of “electronic” payments. For example, the ADA has received complaints from dentists who were directed by dental plans to third-party vendors that applied additional charges for payment processing. These charges are typically tied to “value-added” services bundled in the enrollment process, such as automatic reassociation, expedited payment or practice management integration.
The Q&A also highlights the following key points from the ADA:
• Before signing an EFT enrollment agreement, especially with a third party, dentists should review any added services or ask specifically for a basic, fee-free option that meets the Health Insurance Portability and Accountability Act standard for automated clearing house, or ACH, EFT payments.
• In some instances, a dentist’s bank may charge a transaction fee even for this basic option. This fee is separate and distinct from any dental plan actions. Dentists should look at their bank policies, procedures and associated costs prior to selecting a particular payment method.
• Some plans use virtual credit cards, which are electronic payments that are processed through credit card networks rather than the HIPAA-adopted ACH EFT standard. Because virtual credit card transactions are typically subject to card processing fees, providers are more likely to incur fees when accepting virtual credit card payments than when receiving HIPAA-standard ACH EFT payments.
This is a developing story. The ADA and ADA News will share more information with members as it becomes available.
To learn more about the ADA’s insurance-related advocacy efforts, visit ADA.org/Advocacy or read this ADA News story on 2026 legislative wins.
