AGD Pushes Back on Insurer Fees and Restrictions That Limit How Dentists Get Paid

The Academy of General Dentistry (AGD) recently sent letters to two major dental insurers and two national regulatory bodies opposing policies that restrict how dentists can be reimbursed for their services, arguing the practices penalize providers who prefer paper checks over electronic payment.

The AGD asked Aetna and Delta Dental of California to reverse recently adopted payment policies and called on the National Association of Insurance Commissioners (NAIC) and the National Council of Insurance Legislators (NCOIL) to examine the issue and encourage state regulators to prohibit similar practices industrywide.

“Dentists shouldn’t have to pay a fee, or lose an option altogether, just to get reimbursed the way that works best for their practice,” said Marc J. Worob, DDS, FAGD, president of the AGD. “These policies quietly shift administrative costs and burdens onto the providers who are already doing the work of caring for patients. We’re asking these companies, and the regulators who oversee them, to take a hard look at what these changes mean for independent dental practices.”

Delta Dental of California: A Weekly Fee for Paper Checks

In a letter to Delta Dental of California, AGD requested that the company eliminate a newly implemented $15 weekly administrative fee charged to dentists who choose to receive claim reimbursements by paper check rather than electronic funds transfer. The AGD called the fee an unnecessary burden that shifts the insurer’s own administrative costs onto dental practices and penalizes providers for using a legitimate, long-standing payment method.

Aetna: Eliminating Paper Checks for Out-of-Network Dentists

In a separate letter to Aetna, the AGD urged the company to reconsider its announced plan to discontinue paper checks for out-of-network dentists and require electronic payment instead. The AGD argued that payment methods should remain neutral and should not be used as leverage to influence network participation decisions.

NAIC and NCOIL: A Call for Regulatory Review

The AGD also sent letters to Jeffrey C. Johnston, CEO of the NAIC, and William Melofchik, CEO of NCOIL, laying out both the Delta Dental and Aetna policies as examples of a broader trend. The Academy asked both organizations to evaluate whether such fees and restrictions are consistent with state laws and fair claims payment standards, and to encourage state regulators to prohibit insurers from imposing administrative fees or other restrictions on provider payments.

Across all four letters, the AGD noted that many dental practices rely on paper checks due to established accounting procedures and the cost and complexity of electronic payment platforms. The Academy maintains that dentists should be able to choose their preferred reimbursement method without facing financial penalties or losing the option altogether.