More dental plans are shifting away from issuing paper checks and explanations of benefits for payment of dentists’ services, and dentists may need to take steps to avoid fees.
Delta Dental in a June email to contracted dentists announced that electronic funds transfer will be its standard method of payment beginning Jan. 1, 2027. Delta Dental will also start charging a weekly $15 processing fee to practices that have chosen to continue receiving paper checks for payments.
Other dental plans have announced they are implementing similar changes in their payment methods much sooner.
Guardian announced in EOB messages that “beginning this summer” it will start issuing paper checks every two weeks.
Aetna informed out-of-network dentists in multiple states outside of California that it will no longer issue paper checks and hard copy EOBs effective Sept. 4, shifting to digital payments by way of virtual credit cards or EFT.
While California dentists are not subject to Aetna’s digital payment shift at this time, Aetna representatives told CDA that California dentists can expect to receive information about payment changes in the first quarter of 2027.
Plans must offer a no-fee payment method under state law
CDA-sponsored VCC legislation that was signed into law and took effect Jan. 1, prohibits dental plans from using a default payment that includes a fee, including virtual credit cards. Dentists must opt in to any payment with a fee.
“We can safely assume that Aetna is not yet implementing this payment policy in California because of this law,” said CDA President Robert Hanlon, DMD. “Plans are required to provide options for dentists and can’t default to predatory fee-based payment such as VCCs.”
Additionally, current CDA policy (Dental Plan Payments, 17RC-2023) states that dental plans should offer dentists reimbursement options without mandatory transaction fees.
In most cases, the plans will meet both requirements by offering dentists EFT as a payment option.
The changes announced over the last two months by Delta Dental, Guardian and Aetna reveal a trend: plans are creating incentives for dentists to accept payment through EFT or other electronic means. Other plans could follow suit.
But the trend is also creating administrative burden for dentists with some reporting challenges accessing EOBs or electronic remittance advice for EFT.
CDA has contacted all three plans on behalf of members to clarify their payment policies and has requested that the plans improve their administrative processes.
Ensuring dentists have easy and timely access to claim payments from dental plans remains a top CDA priority.
Relatedly, CDA has commented on the proposed standard for dental EOBs that the American National Standards Institute is developing. Adopting this standard would, among other things, “reduce administrative follow-ups” and improve trust between the dentist and patient through improved payer transparency.
Plans provide some details on payment changes for dentists
Here is what Delta Dental said in its conversations with CDA:
- Delta Dental believes that its $15 fee for issuing hard copy checks complies with current California law and existing CDA policy because it offers EFT as a fee-free default payment method.
- Delta Dental believes it is following best practices for providing and disclosing payments via EOBs and ERAs.
- Dental practices that choose to receive paper checks will only be charged the $15 weekly fee for the weeks they receive a paper check (one fee per week in any week where they receive one or more checks).
- Delta Dental’s plan representatives indicated that the company will share more details with dentists in September.
Guardian noted that its hard copy check runs will occur every two weeks beginning in late August. Here are the details Guardian shared with CDA:
- Approximately 8,000 to 10,000 California dentists have received hard copy checks year-to-date and may be impacted by the two-week check-run frequency.
- Checks will be issued every other Wednesday, rather than weekly.
- Dentists who choose EFT for claims payment will usually be paid five days post-review, and remittance advice/EOBs will be available through the Guardian provider portal.
Aetna is preparing to shift its payment policy for California dentists in early 2027. The company last week responded to CDA’s questions with the following:
- Aetna will provide “a formal and clear consent process” to California dentists in the first quarter of 2027. EFT enrollment is only available through Optum’s Payer Enrollment Services website, not over the phone.
- Optum can address any questions regarding Aetna billing provider enrollment in EFT through its
- All billing dentists can access Aetna’s online portal, regardless of contract status.
- EFT-enrolled dentists can access patient EOBs through the Aetna Dental Provider Portal.
EFT payments—safe, secure and compliant? Q&A for CDA members
Analysts at CDA have heard members’ questions about EFT enrollment and payments. Here are answers to those questions.
CDA recognizes that members are facing increasing administrative burden while providing quality care to patients. There are many dental plan reform efforts to celebrate, but gaps in plans’ transparency persist. CDA is committed to creating a better system for its members and patients, which includes fair and functional contracts for dentists. Learn more in the Dental Plan Action Center.