How to Opt Out of Virtual Credit Card Payments From Dental Insurers, Payer by Payer
A virtual credit card is a payment you already earned, handed back to you with a fee attached. Most practices never agreed to it, and most can switch it off. Here is how, one payer at a time.
What a virtual credit card actually is
When a dental payer reimburses you by virtual credit card, or VCC, it does not send money to your bank. It sends a single-use card number, usually by fax, mail or email, and your team keys that number into your merchant terminal as if a patient were paying by card. The funds arrive net of your card processing fee, typically 2 to 3 percent, and sometimes more once terminal fees stack on top.
Payers push VCCs because the card networks pay them for the volume. Every VCC transaction generates interchange revenue that flows back to the payer or the payment vendor it hired. One processor, VPay, has told insurers in its own marketing that they can make money on every virtual card transaction. The fee you pay is not a cost of doing business for the payer. It is a revenue line.
The four problems
The fee is the obvious one. On a practice receiving a meaningful share of insurance revenue by VCC, 2 to 3 percent of that revenue is gone before it reaches the bank, on money that would have arrived in full by EFT.
The labor is the second. Every card has to be keyed manually, and single-use cards are time-limited, so a card that sits in a stack for a week can be dead by the time someone gets to it, which means a call to the payer to reissue the payment.
Reconciliation is the third, and the one that quietly costs more than the fee. Your practice management system posts the full claim amount. Your bank receives the amount net of the processing fee. Those two numbers never match, and unless someone reconciles every deposit against the remittance, the difference gets written off as a mystery adjustment or never noticed at all. Our guide to auditing dental merchant processing fees covers how to find that drag.
Consent is the fourth. Practices are routinely enrolled in VCC without agreeing to it. One vendor, Change Healthcare, described automatically enrolling roughly 100,000 doctors and hospitals in virtual card payment. The Florida Dental Association has described a system where dentists must opt out repeatedly, sometimes multiple times, to stop receiving them.
How much of your revenue is arriving this way
Rather than estimate, we measured it. Across tens of thousands of insurance payments in our reconciliation data over the past year, this is the share of each payer's payments that arrived as a virtual credit card in the most recent quarter:
| Payer | Share of payments by VCC |
|---|---|
| Liberty Dental | 91% |
| Principal | 80% |
| Guardian | 77% |
| United Concordia | 73% |
| MetLife | 66% |
| UnitedHealthcare | 62% |
| Anthem / BCBS | 61% |
| Cigna | 51% |
| Humana | 19% |
| Delta Dental | 1% |
| Aetna | 0% |
The spread is nearly total. Delta and Aetna essentially never send them. Liberty, Principal and Guardian send them most of the time. Your exposure is set by your payer mix, and most practices have never tallied it. The full methodology is in our report on which dental payers send virtual credit cards.
Who is really sending them
This is the part that changes how you fix it. The card usually does not come from the insurer directly. Most dental and medical payers hire a payment vendor to deliver claim payments, and three vendors issue the large majority of virtual cards: ECHO, Zelis and VPay. Change Healthcare and VPay are both owned by UnitedHealth. Zelis alone delivers payments for well over 500 payers.
That structure has a practical consequence. Because one vendor serves many payers, opting out at the vendor level often switches off virtual cards for every payer that vendor handles for you, not just one. You do not have to know in advance which vendor each of your payers uses. Look at the remittance or explanation of payment that came with the card. It names the vendor, and for ECHO it includes the draft number you need to opt out. That is your starting point.
The opt-out table
Two layers. First, the vendors, since that is where most of the leverage is. Second, the payers, with the routes we could verify.
Vendor-level opt-out
| Vendor | Owned by | How to opt out of VCC and switch to EFT | Verified |
|---|---|---|---|
| ECHO Health | Independent | Opt out at echovcards.com or call 833-201-7641. You will need the ECHO EPC draft number printed on your remittance. Opting out of VCC alone may route you to check; enroll in EFT separately. | Yes |
| Zelis | Independent | Enroll or change payment method through the Zelis provider enrollment form or 855-496-1571. Zelis offers ACH, VCC and check. Ask specifically for standard, fee-free ACH, since Zelis also offers a fee-based expedited EFT. | Yes |
| VPay / Change Healthcare | UnitedHealth (Optum) | Enrollment and payment-method changes run through Optum's payment and enrollment services. Request EFT and decline VCC. | Yes, ownership and mechanism |
Payer-level routes we could verify
| Payer | Our measured VCC rate | How to switch to EFT | Verified |
|---|---|---|---|
| Delta Dental | 1% | Enroll in EFT with Delta directly. EFT becomes its standard method Jan. 1, 2027, and paper checks will carry a $15 weekly fee. | Yes |
| Guardian | 77% | Enroll in EFT through Guardian. EFT-enrolled practices are paid about five days post-review with remittances in the Guardian provider portal. | Yes |
| Aetna | 0% | EFT enrollment is only through Optum's Payer Enrollment Services website, not by phone. | Yes |
| All other payers | See table above | Enroll in EFT through the payer's provider portal, or opt out at the vendor named on your remittance using the vendor table above. | General route |
We have deliberately not listed a phone number or portal for every payer, because those change and a wrong number wastes your time. The reliable path is the vendor on your remittance, then the payer portal. Our reconciliation guide by payer covers each major insurer's payment habits in more detail.
Your rights: federal and state
You have more leverage here than most practices realize.
At the federal level, the HIPAA electronic payment standard, adopted under the Affordable Care Act and codified at 45 CFR 162.1601 and 162.1602, requires that a health plan, on your request, pay your claims by standard ACH electronic funds transfer. The honest nuance: this is a right to a fee-free standard transfer on request, not a blanket ban on every fee. A plan can offer an optional expedited service with a charge. What it cannot do is make the fee the price of getting paid electronically at all. If a plan or vendor will not honor a plain request for standard EFT, the recourse is a complaint to CMS through its Administrative Simplification enforcement system.
At the state level, a growing list of states now goes further and requires your affirmative consent before a payer can send a fee-bearing payment at all. Every state below is verified from ADA, CDA or state dental association sources.
| State | What the law does | Verified |
|---|---|---|
| California | SB 386, signed Oct. 2025. Plans may not use VCC or any fee-based method as the default. Dentists must opt in, can opt out at any time and must be told all fees. Opt-in and opt-out provisions effective April 1, 2026. | Yes |
| Georgia | Existing VCC law strengthened in 2026 from opt-out to opt-in. Insurers must obtain express permission before paying by VCC or any fee-bearing method. | Yes |
| Louisiana | Existing VCC law strengthened in 2026 from opt-out to opt-in, same as Georgia. | Yes |
| Illinois | HB 4464, signed June 26, 2026. Insurers cannot require VCC, must disclose fees, offer alternatives and obtain affirmative consent. Prohibits contractual waivers of the protection. | Yes |
| New York | Insurers must obtain a dentist's consent before reimbursing by VCC or any EFT method that imposes transaction fees. | Yes |
| Wisconsin | 2026 legislation limiting insurers' exclusive use of VCCs, ensuring dentists have a choice of payment method. | Yes |
| Michigan | New VCC law enacted in the 2026 session. | Yes |
| Florida | Law protecting dentists from default VCC payment and the repeated-opt-out burden. | Yes |
| South Dakota | SB 171. Plans may not restrict payment to methods where a credit card is the only option. | Yes |
| Kentucky | HB 370, 2022. Prohibits plans from limiting claim payment to VCC only. | Yes |
| Kansas | Law prohibiting plans from limiting claim payment to VCC only. | Yes |
This list is not exhaustive. The ADA maintains a state-by-state table of virtual credit card laws, and other states have protections we have not individually confirmed here. If your state is not listed, check the ADA's dental insurance reform resources before assuming you have no protection.
If you keep accepting them
Some practices choose to keep VCCs for a payer or two, usually for speed. If that is you, three habits keep it from costing more than it should.
Process the card the same day it arrives, because single-use cards expire and an expired card means a reissue call. Reconcile every card deposit to its remittance, so the fee-net amount in the bank is tied back to the full posted amount and the difference is recorded as a processing fee rather than lost as an adjustment. And separate the person who receives and opens the card from the person who runs it through the terminal. A single-use card number in one person's hands, with no second set of eyes, is a control gap. Our guide to separation of duties and least-privilege access covers why that matters.
How to know if you have a VCC problem today
Three questions, five minutes.
Pull last month's insurance payments and count how many arrived as a card number rather than a deposit. If you cannot answer quickly, that is itself the answer. Then pull your merchant statement and look for insurance-payer names in the card transactions. Every one of those is a fee you paid to receive money you had already earned. Then ask whether anyone at the practice ever affirmatively agreed to VCC payment from any payer. If nobody can remember opting in, you were almost certainly enrolled by default, and in a growing number of states that is no longer allowed.
The practices that fix this recover a few percent of their insurance revenue with a handful of enrollment forms. It is one of the cheapest wins in dental revenue cycle management, and it is sitting in a stack of unprocessed card numbers at most front desks right now.
Frequently Asked Questions
Can I refuse virtual credit card payments from dental insurance?
Yes. Under the federal HIPAA EFT standard you can request standard ACH payment from any health plan, and a growing number of states now require your affirmative consent before a payer can send a fee-bearing payment at all. Opt out at the vendor named on your remittance and enroll in EFT with the payer.
How do I stop insurance virtual card payments?
Identify the payment vendor on the remittance that came with the card, most often ECHO, Zelis or VPay, and opt out at that vendor. Because one vendor serves many payers, that often stops VCCs from several insurers at once. Then enroll in fee-free EFT through each payer's portal.
Which dental insurers use virtual credit cards the most?
In our measured data, Liberty Dental, Principal, Guardian, United Concordia and MetLife sent the majority of payments by VCC, while Delta Dental and Aetna almost never did.
Do virtual credit cards cost dental practices money?
Yes. Each card is processed through your merchant terminal at typical card rates of 2 to 3 percent, sometimes more with terminal fees, deducted from a payment that would have arrived in full by EFT.
Which states require consent for virtual credit card payments?
Verified states include California, Georgia, Louisiana, Illinois, New York, Wisconsin, Michigan, Florida, South Dakota, Kentucky and Kansas, with several strengthened to opt-in in 2026. The ADA maintains a fuller state-by-state table.
Zeldent reconciles every insurance payment against what actually reached your bank, so a card deposited net of a fee never silently becomes a missing balance. If you want to know your real VCC exposure instead of guessing, book a demo and we will show you what your payers are actually sending.
