Collaboration helps drive positive insurance changes in multiple states

Three states find success in removing limits on payment options for out-of-network dentists.

Dental organizations and dentists across the country are delivering positive outcomes via grassroots efforts in opposition to Aetna's out-of-network payment policies.

This summer, Aetna announced an administrative fee for out-of-network dentists who chose to receive paper checks for claim payments. The change raised significant concerns about limiting dentists’ payment options and adding additional fees and administrative burdens onto dental practices.

In response, the ADA developed a template letter for constituent dental societies to share with their dentists, urging Aetna to walk back the policy. Many state dental associations alerted their member dentists, encouraging them to reach out to Aetna to request a change. In addition, the ADA sent a letter to the National Association of Insurance Commissioners, alerting regulators at a national level that Aetna had begun charging a fee to access payment options, and this was becoming a troubling and growing trend. 

The response was swift, and in at least three states so far — Illinois, Oregon and Florida — the advocacy campaign has produced meaningful results.

Illinois: The Illinois State Dental Society, or ISDS, advocated directly with Aetna, raised the issue with the Illinois Department of Insurance and pushed back against the use of fees and administrative processes to limit dentists' options for receiving payments from the insurer.

Aetna ultimately announced that it would not move forward with its planned changes to payment reimbursement methods for Illinois dental providers at this time. ISDS shared the win with members saying, "This is a significant win for Illinois dentists and a great example of why strong advocacy matters," said Eric Larson, Executive Director of the Illinois State Dental Society.

"ISDS has been working for years to protect dentists' ability to choose how they are paid. When Aetna announced this change, we were prepared to act. We pushed back, and we are pleased that Aetna listened and changed course in Illinois," he said.

Oregon: Oregon dentists also saw a change in direction from the insurance provider. In 2023, the Oregon Dental Association, or ODA, championed and helped pass legislation addressing payment opt-in requirements. When this issue surfaced, the Oregon Dental Association ( alerted members to utilize an ADA state template encouraging dentists to contact Aetna directly. ODA also raised the issue with Oregon’s Department of Consumer and Business Services.

After concerns were raised about the company implementing policies that add administrative complexity and divert resources from patient care, Aetna issued a letter of apology stating that the earlier communication about claim payments and explanation of benefits, or EOBs, was sent in error. The insurer clarified that paper checks and EOBs would remain available, while direct deposit would continue to be offered as another option. After the win, the ODA alerted members to explain how dentists’ outreach was impactful. 

“Your voice matters. The more dentists who speak out, the stronger our message that provider choice and fair reimbursement practices must be preserved,” said ODA President Amberena Fairlee, D.M.D., in a communication about the news.

Florida: The Florida Dental Association, or FDA, also challenged the change, calling it “A strong-arm tactic that makes it difficult for providers to accept their preferred payment unless they join its network.”

The FDA encouraged out-of-network dentists to require payment for services at the time of service, submit the claim and have Aetna send any applicable reimbursement directly to the patient. The FDA, alongside the ADA, challenged the proposed policy and urged Aetna not to implement the change.

Following extensive grassroots efforts, Florida dentists received a letter similar to the one sent to dentists in Oregon. Aetna said its previous communication about requiring dentists to enroll in electronic fund transfers or accept virtual credit cards had been sent in error. Dentists were again informed that paper checks and EOBs would remain available, with direct deposit offered as an additional option. 

The outcome in these three states is a notable turnaround from earlier this summer, when the ADA initially asked Aetna to reconsider its plan to discontinue paper checks for out-of-network dentists. At the time, Aetna responded that it had reviewed applicable laws and regulations and would ensure compliance.

“Unified in voice. Unified in purpose. Together, we can push for fairness for providers and patients when insurers stand in the way,” said ADA President Richard Rosato, D.M.D. “Providers know what their practices need to thrive. We’re working together to protect that choice, helping practices remain viable in every community and standing together when insurers try to interfere.”

For the latest information on advocacy efforts led by the ADA, visit ADA.org/advocacy.