For most dental groups, the answer is no, at least not by default. A virtual credit card turns an insurance payment the group has already earned into a card transaction, and the group pays the processing fee. Across several locations and a year of claims, those fees add up to real money. This guide explains how virtual credit card payments for dental groups work, what they cost, what new state laws say, and how to move payers to EFT.
What is a virtual credit card payment from a dental insurer?
A virtual credit card (VCC) payment is a single-use card number that an insurer or its payment vendor sends instead of depositing the claim payment into the practice's bank account. The card usually arrives by fax, mail or portal, and a staff member runs it through the practice's card terminal to collect the money.
Once the card is run, the practice pays merchant processing fees on its own insurance revenue. ADA News has reported that these cards can carry a 3–5% service fee, on top of the practice's normal terminal charges. The claim shows as paid in full, but the group receives less than the payer approved.
Every virtual card has to be keyed in by hand, and every one carries a fee.
Why do dental practices receive virtual card payments?
Practices usually end up on virtual cards by default, not by choice. Payers and their payment vendors save money on check printing and can earn part of the card interchange fee, so cards are often set as the standard payment method unless the practice opts out.
Opting out has historically been hard. The California Dental Association reported that opt-outs were often temporary and that card vendors reinstated virtual cards after dentists declined them. In a multi-location group, it's common for a busy front desk to run a card just to clear a claim, without anyone in finance knowing the payer has switched methods.
How much do virtual card payments cost a dental group?
The cost is the card fee multiplied by the insurance dollars received by card. At 3–5%, every $1 million in virtual card payments costs between $30,000 and $50,000 in fees.
Here is an illustrative example, not a statistic. A dental group receives $10 million a year from insurers, and 30% of it, or $3 million, arrives by virtual card. At a 3% fee, that's $90,000 a year in processing costs on revenue the group had already earned. Use your own merchant statements and payer mix to run the real number, by payer and by location.
The fee isn't the only cost. Staff have to key each card number, correct entry errors, and chase replacement cards when one expires before it's processed. Because the card payment and its remittance details often arrive separately, matching the deposit to the right claims takes extra work. Those unmatched payments show up as unapplied credits, which distort AR and collections reporting. Zentist's comparison of manual vs automated remittance posting shows how much of that matching time automation removes.
Card processing fees come straight out of insurance revenue the group already earned.
Virtual card vs EFT vs paper check: which is best?
Standard EFT (ACH) paired with an electronic remittance advice (ERA) is the best option for most dental groups. It has no card processing fee, arrives directly in the bank account, and carries a trace number that links the deposit to its remittance for faster matching.
Can a dental practice refuse virtual credit card payments?
Yes. Under federal HIPAA rules, health plans can pay by virtual card, but CMS guidance says they must use the EFT standard if the provider requests it. Plans also can't force providers to sign up for a paid vendor service to receive EFT.
In practice, switching is payer by payer. Ask each payer for standard ACH EFT with ERA, not just "electronic payment," because some electronic options still come with fees. Get written confirmation, then verify the first few deposits and ERAs before marking the payer as converted. A central register of each payer's payment method, enrolled entity and bank account keeps locations from slipping back onto cards. This enrollment work is where most groups stall, and it's work Zentist handles: its team manages EFT enrollment with payers so the billing staff doesn't have to chase each one.
What do state laws say about virtual credit cards for dentists?
Several states now protect dentists from being defaulted onto virtual cards. California and Florida have two of the strongest laws, and more states are considering similar bills.
California's SB 386, sponsored by the California Dental Association, took effect for dental plans on April 1, 2026. Plans can't make a virtual card or any fee-based payment method the default, dentists must give affirmative consent to receive cards, and they can opt out at any time. Plans must also explain the alternative payment methods and their fees. Florida's SB 892 applies to contracts issued or renewed on or after January 1, 2025. It bars contracts that limit claim payments to credit cards only, requires fee disclosure and consent before electronic payment, and prohibits ACH transmission fees unless the dentist agrees. Rules and effective dates vary, so check your state dental association before relying on a specific protection.
When is it reasonable to accept a virtual card?
Accepting a virtual card can make sense for an occasional, low-volume payer, where the fee and staff time cost less than the effort of enrolling in EFT. For any payer that pays the group regularly, EFT with ERA should be the policy, and locations should send any new payment-method notice to the revenue cycle team instead of accepting it locally. Zentist's guide to dental RCM for DSOs covers how multi-location groups centralize decisions like this.
How does Zentist help dental groups move off virtual cards?
Zentist handles both halves of the switch: getting payers onto EFT, then making sure every EFT is matched and reconciled. Zentist's team manages EFT enrollment with payers across the group's locations, which removes the payer-by-payer calls and forms that keep most practices stuck on virtual cards.
Once payments arrive by EFT, Remit AI collects the matching ERAs across payers with no portal logins, automatically matches every EFT to its remittance, and reconciles each payment against the bank deposit it arrived in. Because an EFT and its ERA arrive as structured data, Remit AI's Autoposting tool can then post the payment into the PMS automatically, which a virtual card keyed in by hand never allows. That closes the gap that makes card payments so hard to track: no unmatched deposits and no unapplied credits piling up. Salt Lake Pediatric Dentistry, a Zentist customer, now receives 97.58% of its payments through EFT. Zentist's guide to remittance advice in dental billing explains how EFTs and ERAs fit together.
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