If it appears that insurance payers unleash new rules, regulations, policies and even payment methods so quickly, you are not the only one left with your head spinning and your staff scrambling to keep up.

Over the last several months, we’ve been getting more questions from chiropractors about an increasingly common payment method health insurers are offering: virtual credit cards. If you haven’t experienced the virtual credit card payment offer yet in your chiropractic office, consider yourself fortunate and forewarned. Here’s the skinny on this new technique being used by the insurance companies against you and your bottom line.

An increasing number of health insurers are choosing to use virtual credit cards for claims payments to chiropractors instead of sending paper checks or paying via the electronic funds transfer (EFT) standard transaction. On the surface, this solution seems awfully “convenient” simple and perhaps even preferable.

But looks can be deceiving. In reality, virtual credit cards are generally just another way payers are dipping into your pockets to take some more of your money.

How Virtual Credit Card Payments from Health Insurance Payers Work

When paying via virtual credit card, insurers send single-use credit card payment information and instructions to your chiropractic office via mail, fax or email. Your staff then processes the payment as they would a patient’s credit card. So far, so simple.

The big problem lurks in the small details.

For each of the payments issued to your virtual credit card, chiropractors are charged fees that typically amount to 3-5% of your total payment or reimbursement. In other words, for the “convenience” of accepting payments via the virtual credit card, you will potentially lose another 5% off your already reduced fees.

How can insurers do this? On the surface, they are paying the reimbursements correctly via your contract or their published fee schedules. So, in that sense, they are not doing anything wrong.

In fact, when you accept the virtual credit cards, you are typically missing out on the fine print where you basically agree to these fees. Essentially, you give the payer permission to reduce your reimbursement another few percentage points so that they can claim their fee.

Why are More Payers Moving to Virtual Credit Card Payments?

If you’re not mathematically inclined or if you believe that insurance payers are businesses with your best interests at heart, the push to virtual credit cards may not make immediate sense.

Plain and simple, it’s good math (for them) and more money kept in the payer’s pockets.

3-5% on a single chiropractic claim may not seem like much. Especially, when you consider our fees are small compared to most providers. Keep in mind two important principles:

  • The concept of virtual credit cards was not created for chiropractors.
  • Even small fees add up to big dollars with enough volume

When Virtual Credit Cards Get Ugly

Because these cards are pretty much a universally bad deal, you should resist the urge to accept the “convenience” of being paid by virtual credit cards. There really is no upside. You will not be reimbursed any faster (at least enough not to make a significant difference) and you forfeit part of your hard earned money in the process.

If you think that I’m making much out of nothing here, you should also know that the American Medical Association has taken major steps over the last several years to fight the onslaught of virtual credit cards. The AMA has testified to the National Committee on Vital and Health Statistics, an advisory board to the secretary of the U.S. Department of Health and Human Services (HHS), on the evils of these cards.

Why? Well, there are now insurers who are attempting to force providers into accepting payments via virtual credit cards. It’s one thing to make your own bad decision, but it’s another to be forced into one. To combat this, the AMA petitioned the HHS and other leading organizations to prohibit insurers from forcing physicians to accept this payment method.


Fortunately, “forced” virtual credit card payments are rare in chiropractic at this point. Here, we are benefitting from our small size in that we are not the payer’s first target.

But let this post serve to notify you that (for now) your best response is to “just say no.”

If no one buys into the concept of virtual credit cards from the start, it will be much harder for payers to force the issue on us, especially given the battles they are already fighting with the AMA.

If and when you do see payers trying to push this on you, notify your state association and get them to back you up on not making this a payment method that is mandatory and in the process, obligates you to surrender more of your hard-earned money.