Aetna and Out-of-Network Providers Payment Announcement

Aug 25, 2026
Aetna has recently announced that beginning September 4, 2026, out-of-network providers will no longer receive payments via paper check. Aetna has indicated all payments for out-of-network providers will be issued via virtual credit card. Aetna has indicated dentists who do not wish to receive virtual credit cards can enroll in electronic fund transfers to receive payment.

Illinois Law

Illinois currently has a virtual credit card law that prohibits insurers from incurring a fee to receive a payment. Under the current law, dentists must be provided with an alternative payment option. This past legislative session, ISDS passed a law that strengthens this current law and is explicit that the insurer cannot require a dentist to only accept a credit card or electronic funds transfer for payment of services. This new law will go into effect January 1, 2027.

ISDS Action

ISDS has been advocating to maintain the dentists’ ability to choose their payment method of choice. In 2023, ISDS passed legislation to address the issue of virtual credit cards. In 2026, ISDS advocated for and passed legislation to strengthen the virtual credit card law to explicitly prohibit insurers from requiring dentists to have to accept virtual credit cards or electronic funds transfer for payment. The new law will also allow the dentist to “opt-in” to their choice of payment instead of having to “opt-out” of virtual credit card payments.

With the current law and the new law coming into effect very soon, ISDS has requested Aetna to reverse their policy decision. ISDS is in discussions with the Illinois Department of Insurance (IDOI) regarding the new Aetna policy and how the current law and forthcoming law prohibits Aetna’s new policy. Our discussions and advocacy efforts are ongoing.

Options for Dentists

As we continue our efforts, you, the dentist, have the option to engage the patient in the payment process by the following:

  • Out-of-network dentists can have patients pay at the time of service, still submit the claim for the patient, and have Aetna reimburse the patient directly.

    If patients complain about this new process, we have established talking points for you to use to explain the changes that Aetna has made to create this situation.

 

 

ISDS Aetna Talking Points -Dentist to Patient

  • Aetna has changed the way they have reimbursed dental offices that are not in their network.
  • Aetna has announced since we are out-of-network they will no longer issue paper checks to our office.
  • Aetna’s new policy essentially requires us to pay a fee to be paid for the services we provide.
  • Due to Aetna’s change in policy, we will require payment upfront at our office.
  • Following payment at our office, you can seek reimbursement directly from Aetna by submitting an insurance claim to them directly.
  • If you would like, we can still submit the insurance claim to Aetna for you, but you will have to seek your own reimbursement from them.
  • We value you as a patient but unfortunately this is out of our control.
  • We understand your frustration with this process so I would encourage you to contact Aetna directly and talk to your employer’s HR team and let them know of your frustrations.