May 27, 2020

Editor’s Note: This is the 32nd story in the Decoding Dental Benefits series, which provides answers and solutions for dentists in the world of dental plans and benefits. The series is intended to help unravel many of the issues that can potentially confuse dentists and their teams so that they can focus on patient care.

Electronic fund transfers should be free.

According to the Code of Federal Regulations, “a health plan cannot charge fees or costs in excess of the normal telecommunications fees or costs that the entity incurs. “

However, billing providers often add transaction fees for so-called “value-added” services. These services vary, but sometimes they include hotlines that dentists can call if they have any problems.

“There should be no charge for EFT,” said Dr. Sara Stuefen, general dentist in Vinton, Iowa, owner of her practice and member of the ADA’s Council on Dental Benefit Programs. She said she had heard complaints from fellow dentists about the extra charges, and dentists shouldn’t have to bear them.

Dentists who do not wish to bear the transaction costs are encouraged to ask providers if payments can be received without the “added value” and therefore free of charge, she said.

What bothers her even more is when third-party payers send dentists virtual credit cards as payment. The dental office increases its operating costs by paying a merchant service fee to process the 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 via a virtual credit card, Dr Stuefen, who has been managing EFTs in his practice for nearly a decade, said, “Don’t be afraid to tell a payer that you ne I don’t want to receive virtual credit cards. Be proactive.”

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

“Dental offices will have to ask health plans and clearinghouses what these value-added services are,” Smith said. “EFT and electronic remittance advice are simple transactions mandated by the federal government. These are not value added services.

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

“In fact, many dentists we spoke to have chosen not to receive virtual credit cards for payment,” Smith said.

Photo by Sara Stuefan
Dr Stuefen

If a dentist believes entities are unfairly billing EFTs, Smith said, and refuses to pay through the no-charge version of the EFT transaction, dentists should consider filing a formal complaint directly with the Centers for Medicare & Medicaid Services. .

“Some practices have reported that it was sufficient to simply request the EFT option at no cost,” Smith said.

Dr Stuefen and Mr Smith together presented an ADA webinar called ACHing for EFT in January which was recorded and is free for on-demand viewing for members of the ADA Center for Professional Success. The webinar focuses on how dentists can reduce their practice overheads through the use of electronic data interchange and how EFTs through Automated Clearing Houses (ACHs) could reduce time and effort. manuals – and the costs – associated with receiving and processing paper checks.

“EFT means dentists get their hard-earned money quickly, safely and at a very low cost,” Smith said. “Payments for claims go directly to a firm’s bank account. No waiting for the arrival of checks; no trips to the bank; no waiting for check cashing; no lost checks. Who wouldn’t like that?

Payers also cannot recover money through the EFT / ACH process without the permission of the dentist.

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

Staff at the Center for Dental Benefits, Coding and Quality can help dentists resolve dental benefits and coding issues, questions and concerns. Call the ADA Third Party Payer Concierge at 1-800-621-8099 or email [email protected]

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