The Practicon Viewpoint by Ann Page Griffin

ELECTRONIC FUNDS TRANSFER (EFT)

DO YOU HAVE TO ACCEPT PAYMENT BY EFT FROM THIRD-PARTY PAYERS?

More and more, insurers and other third-party payers are reimbursing providers via electronic payments or virtual credit cards in place of paper checks. The big question for dental practices is: will dentists remain free to choose the method by which insurers reimburse them?

Of primary concern to dentists are decrees by a number of third-party payers that health care providers must accept EFT payment, thereby eliminating the option of receiving paper checks. One example of the problem with EFT is payment by virtual credit card. These single-use electronic cards typically charge a 3% fee. So, by accepting a virtual credit card payment, the dentist must pay (as in lose) 3% of his or her fee. When you think about it, this is actually a penalty for making the insurer's job easier and cheaper, because there is no paper check to generate, address, and pay to mail.
Help for the dental profession has come in two ways:

1. The ADA has successfully lobbied a number of third party payers to get them to agree that individual dentists may choose to continue to receive paper checks for their claims reimbursements. An official position was stated in Resolution 34 passed by the ADA House of Delegates in 2017, stating that the ADA opposes dentists being forced to accept any form of EFT over the option of receiving paper check reimbursements.


2. Individual states are passing legislation to allow health care providers to choose the method by which they receive reimbursement: electronic or paper. For example, on January 1, 2019, Georgia's new law, HB 818, went into effect, making it the second state to safeguard a health care provider's right to choose the method of reimbursement for services rendered.

EFT is rapidly becoming the preferred method of reimbursement due to speed and efficiency. However, the ADA reports that the change is generating many questions from dentists and their team members who handle payment processing. The ADA Center for Dental Benefits, Coding and Quality is handling the onslaught of concerns and questions. The Center for Dental Benefits can be reached by phone at 800-621-8099 or by email at dentalbenefits@ada.org. You can also download an electronic funds transfer implementation checklist free of charge from the ADA to assist you.

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