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Written by Shelley DeGroff, Founder & CEO of PPO Advisors

Last Updated: August 18, 2026

The Aetna virtual credit card is now the default payment method for out-of-network dental practices, replacing paper checks unless the practice enrolls in free direct deposit first. A virtual credit card carries merchant processing fees, so every Aetna claim payment shrinks by roughly 3 to 5 percent before it reaches your bank account.

This applies to out-of-network dental offices, and the notices have gone out in at least three waves since June 2025, each giving about 60 days before the switch. If your office has not received a notice yet, expect roughly two months of warning when it arrives.

Here is what the Aetna virtual credit card notices say, what the default costs you, and what to do before your effective date.

 

What Do the Aetna Virtual Credit Card Notices Say?

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Every Aetna virtual credit card notice reviewed by PPO Advisors says the same five things: paper checks stop, paper EOBs stop, the virtual credit card becomes the default, direct deposit is available only if you enroll, and remittance detail moves behind a portal login.

Each notice is signed by Chad Cressler, AVP of Aetna Dental, and carries the same headline: claim payments and Explanations of Benefits are going digital. The wording has barely changed in a year. Dental offices have been posting their notices publicly as they arrive, and PPO Advisors has reviewed four of them across three separate waves.

Notice Date	Sent From	Effective Date
June 15, 2025	Sent to a Georgia practice	August 15, 2025
March 2, 2026 (plus a reminder mailing)	Hartford, Connecticut	May 1, 2026
July 6, 2026	Branchburg, New Jersey	September 4, 2026

Same format, same signature, same enrollment site, same virtual credit card default. Only the dates change. Every wave gave roughly 60 days of notice.

The five specifics inside each notice:

• Paper checks stop. Your office will no longer receive paper check payments.
• Paper EOBs stop too. This part is getting almost no attention, and it should.
• Virtual credit card becomes the default. As of your effective date, payments arrive by virtual credit card unless you have acted first.
• Direct deposit is available, but only if you go get it. Enrollment runs through PayerEnrollServices.com by the same date.
• EOBs move behind a login. Remittance detail for both payment types is retrieved from AetnaDental.com after creating an account.

The American Dental Association went public on July 22, 2026 and asked Aetna to reconsider, raising the possibility that the policy conflicts with payment choice statutes already on the books in several states. As of that article, Aetna had not responded. That coverage put this on the profession’s radar, but offices have been living with it for over a year.

 

How Much Does an Aetna Virtual Credit Card Cost a Dental Practice?

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An Aetna virtual credit card costs a dental practice roughly 3 to 5 percent of every claim payment, based on virtual credit card service fee ranges documented by the American Dental Association, plus whatever your own terminal charges.

Aetna states in the footnote of its own notice that standard merchant fees apply when processing a virtual credit card, that those fees are a percentage of the transaction amount, and that they process through your point-of-sale terminal. In plain terms, the default payment method takes a percentage of every claim payment before it reaches your bank account.

Aetna does not publish a rate, and it would not be Aetna’s rate to publish. What a virtual credit card actually costs you depends on your own merchant processing agreement. Two practices receiving identical payments can lose different amounts.

Do this math with your own numbers rather than these. Pull your monthly Aetna out-of-network total, apply the effective rate on your own merchant statement, and multiply by twelve. Your rate may be better or worse, which is exactly why it is worth checking before your date rather than after.

Aetna presents this as a modernization of claim payment. The view of PPO Advisors is that for an out-of-network practice the practical effect is a reduction in what you collect, applied to dentists who never signed a contract agreeing to it. Reasonable people can frame that differently, but the arithmetic on your deposit is the same either way.

 

Can Out-of-Network Dentists Still Get Paper Checks From Aetna?

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Based on the notices reviewed, out-of-network dentists can only keep Aetna paper checks by becoming contracted providers in Aetna’s network. Each notice states that dental providers who are contracted with Aetna may select their preferred delivery method, including paper checks.

The notice then directs you to scan a QR code and complete a form to learn about becoming a participating provider, and tells you a network representative will contact you.

The ADA has described this policy as a tactic that makes it difficult for a provider to receive their choice of payment unless they join Aetna’s network. Reading the notice directly, PPO Advisors finds that characterization consistent with how the options are laid out on the page. Aetna may describe its reasoning differently, and has not publicly done so as of this writing.

Some offices that pushed back have reported similar experiences. One practice that asked Aetna how to keep paper checks reported being told that going in network was the route. That office reported calling several times, receiving different answers from different representatives, and finding nobody able to restore check delivery. These are accounts from individual offices, not confirmed Aetna policy. Your own experience may differ, and a single call is not a policy.

If your team plans to call and push back on the Aetna virtual credit card default, set expectations accordingly. Put your request in writing so you have a record of the answer you were given.

To be fair to Aetna: direct deposit is a genuine alternative and most offices should take it. But consider how the menu is arranged from where a practice sits. The default costs you a percentage of every payment. The free and familiar option is described as available to contracted providers. The middle path requires you to find a third party website and enroll before a deadline. Whatever the intent, the practical effect on an office that does not open its mail is the same.

 

What Is the Difference Between ACH EFT and a Virtual Credit Card?

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HIPAA standard ACH EFT is a true bank to bank direct deposit under the HIPAA adopted standard, while a virtual credit card is a payment that runs through credit card networks and carries processing fees. This distinction decides whether Aetna’s change costs your practice money.

Payment Method	Fee to Your Practice	How You Get It
HIPAA standard ACH EFT	Free from Aetna (your bank may charge a small transaction fee)	Enroll at PayerEnrollServices.com before your effective date
Virtual credit card	Merchant processing fees, generally 3 to 5 percent per ADA documentation	Automatic default if you do nothing
Paper check	No processing fee	Described in the notice as available to contracted providers

Aetna states on its own provider pages that it does not charge a fee for EFT. The ADA reports it has not yet encountered a payer charging for this type of payment. Virtual credit cards, by contrast, mean you receive less than the amount on the EOB. Every single time.

Your leverage here is federal. CMS has clarified that when a provider requests payment through the HIPAA adopted ACH EFT standard, the health plan must comply, and cannot require you to accept a virtual credit card as a condition of payment. That right comes from 45 CFR 162.925(a)(1), and a contract clause cannot waive it.

One practical note that will save your team an afternoon. The ADA advises that to get off a virtual credit card you usually have to call the card issuing company rather than the dental plan. The ADA has received reports that those representatives are often reluctant to waive the card, and that dentists have had to escalate to a supervisor to get it done. Plan for that call to take longer than it should.

 

Is PayerEnrollServices.com Legitimate?

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Yes, PayerEnrollServices.com is Optum’s Payer Enrollment Services platform, and it is the established route Aetna uses for both medical and dental provider EFT enrollment. Aetna has committed in writing on its provider pages that it does not charge a fee for EFT.

At the same time, the ADA has received complaints from dentists who were directed by dental plans to third party payment vendors that then applied their own charges. Those charges are usually bundled into value added services during enrollment, such as automatic reassociation, expedited payment, or practice management integration.

This is not an allegation about this platform. It is a reason to read what you sign and to ask specifically for the basic, fee free HIPAA standard ACH EFT option.

 

What Happens to Paper EOBs?

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Paper EOBs stop on the same effective date as paper checks, and remittance detail moves to AetnaDental.com behind a login your office may not currently have.

For an out-of-network office, that means somebody on your team now has to maintain a portal account, log in, pull EOBs, and match them to deposits for a carrier you have no contract with. That is real staff time nobody is paying you for.

Decide now who owns that task. On your effective date it becomes somebody’s job whether you assigned it or not.

 

Why Do Out-of-Network Dentists Have Less Legal Protection?

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Most state payment choice laws, including New York’s new virtual credit card law, protect only providers who have a contract with the carrier, which leaves out-of-network dentists largely outside those protections. This gap is why the Aetna virtual credit card policy is harder to fight than Delta Dental’s paper check fee.

State legislatures have spent years building protections around payment methods. Those protections are real and they are growing. But the New York State Dental Association spelled out the consequence in August 2026. Out-of-network providers are not entitled to advance notice from insurers, and they do not get the 30 day window to select a payment method. The legal requirement to offer at least one fee free method attaches to the contractual relationship, and an out-of-network dentist does not have one.

It goes further. NYSDA notes that insurers are under no legal obligation to send payment directly to an out-of-network dentist at all, even when the patient directs on the claim form that payment go to the treating dentist.

Read together, that suggests many of the protections the ADA and state associations have won largely stop at the network boundary. That is the seam this policy runs through, and it is why the answer for most out-of-network practices is more strategic than legal. If your state’s statute reads differently, or your state association reads it differently, follow them.

The Patient-Direct Payment Option

One option deserves real consideration, and NYSDA raises it directly. An out-of-network practice can collect its fee from the patient, submit the claim on the patient’s behalf, and have the payment directed to the patient. It is a harder conversation at the front desk and it changes your collections workflow. It also takes the carrier out of the middle of your money entirely. For some out-of-network practices, that math works better now than it did a year ago.

 

How Wide Is the Aetna Rollout?

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Every Aetna virtual credit card notice reviewed so far went to a practice that is out of network with Aetna, which is consistent with how the ADA has described the policy. It would be unwise to assume it stops there permanently.

When Aetna made a comparable move on the medical side beginning in 2021, the paperless changeover applied to participating and non-participating providers alike, with the virtual credit card as the fallback for anyone not enrolled in EFT. Whether the dental rollout follows the same path is not something Aetna has stated. This is a parallel, not a reported plan.

As for sequencing, nobody outside Aetna knows. Aetna dental plans are underwritten by different legal entities depending on the state, which would make a staged state by state rollout unsurprising. But the earliest notice went to a Georgia practice, and Georgia already had virtual credit card regulation on the books at the time, so existing state law does not cleanly explain who got a notice and when.

Here is how the rollout gets mapped. If your office received one of these notices, send PPO Advisors a copy along with five things:

• Your state. The single most useful data point.
• The date printed on the notice and whether it is an original or a reminder.
• The effective date. So far: August 15, 2025, May 1, 2026, and September 4, 2026.
• The document control number in the footer. One notice reviewed reads 1399079-01-01. Different numbers indicate different print runs.
• What you were told if you contacted Aetna. Especially anything you received in writing.

With enough of these the rollout can be mapped properly, and the findings will be published on the PPO Advisors blog.

 

What Should You Do Before Your Effective Date?

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Enroll in HIPAA standard ACH EFT by name before your effective date, because doing nothing puts your practice on the Aetna virtual credit card automatically. Then work through the rest of this list.

• Step 1: Find your notice and read the date off it. Effective dates seen so far are August 15, 2025, May 1, 2026, and September 4, 2026. Yours may differ. Do not rely on a date from a forum post.
• Step 2: Decide deliberately, and decide early. Doing nothing is a decision, and the decision it makes for you is the virtual credit card.
• Step 3: Request HIPAA standard ACH EFT by name. If the process steers you toward a card product, push back and cite 45 CFR 162.925(a)(1).
• Step 4: Read the enrollment agreement line by line. Look for bundled value added services and any per transaction charge.
• Step 5: Set up a dedicated EFT account. The ADA recommends a separate bank account for payer deposits, view only access for the staff who reconcile, and a debit block so funds cannot be pulled without your authorization.
• Step 6: Confirm your bank can display addenda data. You need the reassociation trace number to match deposits to remittances. Ask before you enroll, not after.
• Step 7: Assign the EOB retrieval task. Somebody has to own the portal login and the reconciliation.
• Step 8: Check your state law, then check whether it covers you. Many payment choice statutes reach contracted providers only. That distinction decides whether you have a legal argument or only a strategic one. Contact your state insurance commissioner if you believe this conflicts with your state’s law.
• Step 9: Do not let this alone drive a network decision. Joining Aetna to recover a payment method is a far larger financial decision than the processing fee. Run the numbers first.

The other half of this story: Delta Dental is charging contracted dentists $15 a week to keep receiving paper checks beginning January 1, 2027. If you participate with Delta, read Delta Dental Will Charge $15 a Week for a Paper Check Starting January 1.

The fee schedule is not the only place a carrier takes money out of your practice. Payment mechanics, remittance formats, network leasing, and administrative charges all move real dollars, and they move them quietly because almost nobody negotiates them. Across 2,870+ dental practices PPO Advisors has worked with, this pattern repeats: a percentage taken off every payment is a fee schedule cut. It just arrives in a footnote instead of a contract.

Pay attention to how you get paid, not only how much.

 

The Bottom Line

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• The Aetna virtual credit card becomes the default payment for out-of-network dental practices on their effective date, with no grace period.
• Virtual credit card fees generally run 3 to 5 percent per payment, roughly $3,600 to $6,000 a year on $10,000 a month in Aetna volume.
• HIPAA standard ACH EFT is free from Aetna, and federal rule 45 CFR 162.925(a)(1) requires the plan to comply when a provider requests it.
• Most state payment choice laws protect contracted providers only, so out-of-network dentists must act strategically rather than wait for a legal fix.
• Enrollment deadline and switchover happen the same day, so the safest move is enrolling in EFT well before the date on your notice.

 

Frequently Asked Questions About the Aetna Virtual Credit Card

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Does Aetna charge a fee for virtual credit card payments to dentists?

Yes, Aetna virtual credit card payments carry standard merchant processing fees, stated in Aetna’s own notice as a percentage of each transaction processed through your point-of-sale terminal. The ADA has documented virtual credit card service fees generally running 3 to 5 percent. Your exact cost depends on your merchant processing agreement.

 

Can a dentist refuse an Aetna virtual credit card payment?

Yes, a dentist can request payment through HIPAA standard ACH EFT instead of an Aetna virtual credit card, and under 45 CFR 162.925(a)(1) the health plan must comply with that request. In practice, the ADA advises that removing an existing virtual credit card usually requires calling the card issuing company, and dentists have sometimes needed to escalate to a supervisor.

 

Is Aetna’s EFT enrollment free for dental practices?

Yes, Aetna states on its provider pages that it does not charge a fee for HIPAA standard ACH EFT, though your own bank may charge a small transaction fee. Enrollment runs through PayerEnrollServices.com, Optum’s Payer Enrollment Services platform. Read the enrollment agreement carefully and decline bundled value added services if you only want basic, fee free EFT.

 

Does the Aetna virtual credit card policy apply to in-network dentists?

No, every notice reviewed so far went to out-of-network dental practices, and Aetna’s notices state that contracted providers may select their preferred payment method, including paper checks. When Aetna made a similar change on the medical side starting in 2021, it eventually covered participating providers too, so in-network dental offices should keep watching.

 

What happens if I ignore the Aetna notice?

If you ignore the Aetna notice, your office is switched to virtual credit card payments on the effective date and stops receiving paper checks and paper EOBs. Every payment then loses a merchant processing percentage, and your remittance detail sits behind an AetnaDental.com login until someone on your team retrieves it.

 

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✍️ Shelley DeGroff
Founder, PPO Advisors