Alert: TMA Warns of Fees via Virtual Credit Card PaymentsDecember 5, 2022
Nashville, TN — TMA recently assisted a medical practice that received virtual credit cards (VCC) as payment for submitted claims from a third-party billing company. This one was called Zellis, but there may be other third-party payers that take a similar aggressive approach with your practice. Zellis took the incorrect position that:
- The practice had to accept payment via a VCC or EFT with a 1.9% fee.
- If the practice wanted to be paid via a paper check, it must check with each insurance plan to see if the plan would be willing to pay via a paper check. If the plan refused, then the practice had to accept the VCC or EFT with a 1.9% fee. Of course, the insurer took the incorrect position that its hands were tied by the third-party payer.
The practice confronted Zellis with information about federal law provided by TMA and it changed its stance immediately and agreed that the practice did not have to use the VCC or use EFT with a 1.9% fee.
Guidance from CMS in March 2022 makes it clear that health plans cannot require a medical provider to agree to receive payment or reassociation services from a vendor of the health plan’s choosing as a condition of receiving health care EFT payments or ERA using the adopted standards. A health plan must comply if a provider requests claims payment using the adopted HIPAA EFT and ERA transaction standards. Doing so saves a practice from being on the hook for the virtual credit card charges of 3-5%.
TMA recommends that if the insurer’s vendor requires payment with virtual credit cards, first contact the vendor and insist on check payment. If that does not work, contact the insurer and request payment via EFT instead of VCC. If the insurer refuses to comply with your request or you are unable to contact the insurer, it is important that a complaint be filed with CMS. An increase in complaints notifies CMS that this is a problem and aids in our advocacy efforts. You may file a complaint via CMS’ online form, click on Get Started on lower left side of the page and then select Transactions as the complaint type. TMA helped a practice with this process and it won so we know the process works.
If you have any questions, please contact TMA's legal team at firstname.lastname@example.org.