NMDA Journal Winter 2019-20

nmdental.org 13 continues on page 14  WHEN 3 IS 1 TOOMANY Tom Schripsema, DDS Third-party issues are a top concern of New Mexico dentists. A recent survey found den- tists have universally had challenges with third-party payments and that these issues are consistent cause of concern and frustra- tion in their offices. Many of these issues adversely affect patient’s coverage and may affect their ability to receive services. Dentists were vocal about their frustrations and re- ported many incidents as examples from just the month prior to completing the survey. The issues below, along with the “network leasing”were some of their top concerns. Virtual Payments Offices receive payments in multiple ways. Traditionally checks and cash were the most common method for both patients and third- party payers to make payments. These re- quire some processing time in the office, but generally do not cost the practice anything to use. For patients’ convenience offices began to take credit cards. They allowed patients to pay for treatment even if they didn’t have the full amount in the bank at the time. Offices accepted the cost of processing fees as part of doing business and could justify the lost revenue based on the timeliness of payment and receiving full payment immediately. In the last two decades, the use of plastic to pay dental bills has skyrocketed as patients were given rewards incentives to use their cards as their primary means of financial transactions. For many millennials, the use of a check is unheard of. As a result, the cost of credit card processing is a significant cost to most offices. In the last 5–10 years, third-party payers have increasingly turned to the use of “virtual” credit cards to reimburse claims. Instead of sending a check, offices are provided a tem- porary “credit card” number along with an expiration and CVV number, which must be processed through their credit card terminal to receive payment. The amount is limited by the reimbursable amount of the claim. This method of payment is frustrating to many offices because not only is there a fee as- sociated with the transaction, but it must be processed at the hand-processed rate which is often higher than the cost when processing a physical card. Adding to this concern, are reports that some insurance companies have set themselves up as the credit processor al- lowing them to keep a portion of the transac- tion fee themselves. These virtual credit cards not only cost more to process, but also have the worst quality of receiving a check which is the added time waiting for the claim to be processed and the EOB to be sent by mail. Several states have passed legislation that requires dental benefits companies to give offices the choice of receiving payment via check, virtual credit card, or direct electronic deposit, if offered. Offices would then have the choice to receive payments via the meth- od most conducive to their businesses. Retroactive Denial Having claims denied for any reason is certainly a frustration for offices. It often Third-party issues are a top concern of New Mexico dentists. A recent survey found dentists have universally had challenges with third-party payments and that these issues are consistent cause of concern and frustration in their offices.