Dental virtual credit card payments: fees and opting out
A virtual credit card payment is an insurance payment sent as a single-use card number. The practice runs the card and the processor keeps its fee, so the practice receives less than the payer paid. You can opt out: ask the payer or its payment vendor for EFT, which a health plan has to use under HIPAA when you ask.
Book a demoBy Dr. Maya Arnaout, DDS, VP of RevenuePublished 6 min read
Key takeaways
- A virtual card is an insurance payment sent as a single-use card number. The processor keeps its fee, so the practice receives less than the payer paid.
- The fee is not the only cost: each card is keyed by hand, and the money lands mixed into a card payout instead of as its own deposit.
- You can ask for EFT instead. Under HIPAA, a health plan has to use the standard EFT when a provider asks for it.
- Ask for every tax ID and location, enroll for the ERA at the same time, and check that the next payments arrive by EFT.
- Post the full amount the payer paid. The fee is the practice’s cost, booked in the accounts, never written off on the patient.
How virtual card payments work
The payer, or a payment vendor working for it, sends the practice a card number, an expiry date, a security code and the exact amount, by fax, mail, email or portal, usually with a remittance listing the claims it pays. Someone at the practice runs the card through the office’s terminal for that amount, and the card processor pays it out, minus its fee, with the rest of that day’s card payments.
Some practices start receiving virtual cards without having asked for them, with the opt-out instructions in the small print. The remittance is often a PDF rather than an 835, so it has to be read and posted like a paper EOB. See virtual credit card payments in the glossary.
What virtual card payments cost the practice
The processing fee
The card is run like any card payment, so the processor takes its percentage from the payout. The payer paid the full amount on the claims; the practice receives less.
Staff time
Each card is keyed by hand at the terminal, its remittance matched to the claims, and each claim posted.
Harder reconciliation
The money arrives inside a card processor payout, mixed with patient card payments, not as its own deposit with a trace number.
Expiry
A card that is not run before it expires has to be reissued, and the payment waits.
How to see what virtual cards cost you
Before calling payers, find out which ones matter. Your processor’s rate is on your merchant statement; apply it to each card payment and add them up by payer.
| Track | Where it comes from |
|---|---|
| Payments received by virtual card | From the card notices and remittances, by payer |
| Processing fees on those payments | Your processor’s rate on your merchant statement, applied to each card |
| Fee share by payer | Fees on that payer’s cards ÷ that payer’s card payments |
| Cards that expired or were reissued | The ones that waited too long on a desk |
Start with the payers whose cards cost the most. The fee share by payer is also the evidence to have in hand when you ask them for EFT.
How to opt out of virtual card payments
Find who sends the card
Read the card notice. It is often sent by a payment vendor working for the payer, and the vendor is the one to call.
The opt-out instructions are sometimes in the small print of the notice itself. Keep a copy.
Ask to be paid by EFT
Call or write to the payer or its payment vendor and ask for EFT, a direct ACH deposit, instead of virtual cards.
Under HIPAA, a health plan has to use the standard EFT when a provider asks for it. If the vendor offers EFT only with paid extras, ask for the standard EFT instead.
Cover every tax ID and location
Ask for EFT for every tax ID and location the payer pays, not only the one on the notice in your hand.
Otherwise one location switches to EFT and the others keep receiving cards.
Enroll for the ERA at the same time
Ask for the 835 file with the EFT, usually through your clearinghouse, so each deposit comes with a remittance to match it.
Use the same tax ID and NPI as your claims. The EFT and the ERA then carry the same trace number.
Write it down and check
Note the date you asked, who you spoke to and any reference number, then check that the next payments from that payer arrive by EFT.
If cards keep coming, follow up with your notes. Enrollment can take time to become active, and it can lapse after a change of bank, address or ownership.
Have these ready before you call:
- Card notice in hand, with the payer and the payment vendor named on it.
- Legal name, tax ID and billing NPI, the same as on your claims.
- Bank routing and account numbers, with a voided check or bank letter if asked.
- Every location and tax ID the payer pays you under.
- A note of the date, the person and the reference for the request.
The HIPAA standard EFT
How to post a virtual card payment
Some cards will keep coming while requests take effect, and some payers take longer than others. Post each one the same way:
| Amount | Where it goes |
|---|---|
| What the payer paid | Posted in full to each claim on the patient accounts, the same as a check or EFT |
| The processing fee | Booked as a card fee expense in the accounts, never as a patient adjustment |
| The processor’s payout | Matched to the bank deposit, net of the fee, alongside that day’s other card payments |
Run each card the day it arrives, before it can expire. Then the processor’s payout, the remittance and the bank deposit can be tied together: see payment reconciliation and reconciliation.
How ScoutIQ handles it
ScoutIQ reads virtual card payments and their remittances like any other payment and posts what the payer paid to each claim in your practice management system, one of 59 it supports. Cards can be processed inside ScoutIQ with the card fee split out, each one is matched to the remittance that explains it and to the bank deposit, and the fee is booked to QuickBooks or Xero.
ScoutIQ does not enroll you for EFT: that is done with each payer or through your clearinghouse. Until a payer switches, its cards are read, posted and reconciled with the rest. 95% of insurance payments match their EOB with no human review, and most practices are live in 48 hours.
ScoutIQ product
Insurance Billing Automation
Insurance Billing Automation
ERAs and EOBs read; EFT, check and card payments reconciled.
See Insurance Billing Automation