The American Dental Association has come out firmly against a new Delta Dental of California policy that charges dentists a weekly fee to be paid by paper check rather than electronic funds transfer. Member dentists in multiple states forwarded the ADA copies of a newsletter announcing the change, which the ADA has since flagged as an unfair cost shift onto practices that simply want to choose how they get paid.

Delta Dental of California isn't just a California carrier. The enterprise also operates as Delta Dental of the District of Columbia, Delta Dental of Pennsylvania (covering Pennsylvania and Maryland), Delta Dental of West Virginia, Delta Dental of Delaware, and Delta Dental of New York, plus Delta Dental Insurance Company, which serves Alabama, D.C., Florida, Georgia, Louisiana, Mississippi, Montana, Nevada, Texas, and Utah. That footprint means the new paper-check fee has the potential to touch dental practices across a large swath of the country, not just one state.

On July 8, the ADA sent a letter to the National Association of Insurance Commissioners asking the group to oppose the policy and to encourage state insurance commissioners to exercise regulatory oversight. ADA President Richard Rosato, D.M.D., and Executive Director Nader Nadershahi, D.D.S., M.B.A., Ed.D., argued that small dental practices feel administrative cost increases more acutely than larger organizations, and that preserving payment choice helps keep practices viable in both urban and rural settings while supporting patient access.

Shelley Olson, D.D.S., chair of the ADA Council on Dental Benefit Programs, put a sharper point on the underlying economics: insurers may see electronic funds transfer as a free way to modernize payments and cut their own administrative costs, but that framing ignores the burden and cost-shifting it creates for dental offices — time and money that comes directly out of resources that could otherwise go toward patient care.

The ADA also noted that Aetna has separately moved to eliminate paper checks entirely for out-of-network providers in several states, suggesting this isn't an isolated Delta Dental decision but part of a broader industry trend toward pushing providers off paper payments.

For solo and small-group practices already managing thin administrative margins, a $15-per-week fee adds up to roughly $780 a year just to receive payment in the format a practice prefers. Multiply that across every practice location, and multiply it again across every payer that decides to follow Delta Dental's lead, and the cumulative effect on overhead could be significant — particularly for practices in rural or underserved areas where switching to EFT may not be a simple administrative lift.

The ADA's position isn't that EFT is bad; it's that providers, not payers, should decide which payment method fits their practice, and that decision shouldn't come with a penalty attached.

The ADA is encouraging dentists to take action on three fronts:

The ADA has characterized this as a developing story and says it will share more information with members as it becomes available. Practices currently enrolled with Delta Dental of California or its affiliated entities should watch for direct communication from the payer about implementation timing, and should factor the potential fee into their administrative cost planning if EFT enrollment isn't already in place.

Source: American Dental Association, ADA News, July 9, 2026.