exact balance, effectively absorb- ing the surcharge cost themselves. Even more concerning, the reported surcharge can trigger audits from insurance companies, potentially leading to reduced reimbursement rates for procedures.


Many dental practices find that in- creasing prices by a modest percent- age — without adding a separate surcharge — is a better way to offset rising operational costs. This strategy allows practices to maintain transparency with their patients while avoiding the negative percep- tions associated with surcharges.


NAVIGATING THE COMPLEXITIES OF SURCHARGING


For practices that still wish to explore surcharging, navigating the complex regulations is crucial. Visa, Mastercard, Discover and American Express each have strict guidelines that must be followed. If a practice decides to surcharge any credit cards, they must surcharge all credit cards, maintaining consistency across all transactions. However, debit cards cannot be surcharged un- der any circumstances, which adds another layer of complexity.


Additionally, businesses cannot surcharge customers from states where surcharging is illegal, even if the practice is located in a state where it is permitted. Surcharges are also capped at the average process- ing fees paid over the past quarter, up to a maximum of 3 percent for Visa and 4 percent for the other card brands. This is why many processors default to a flat 3 percent rate. These rules apply regardless of how the surcharge is labeled — whether as a “Cash Discount” or otherwise — any additional fee added based on the type of card needs to comply with card brand regulations, state and federal laws.


Surcharging requires careful consid- eration, strict adherence to regula- tions and transparent communica-


tion with patients. The potential cost savings must be weighed against the risks of losing patient loyalty and damaging the practice’s reputation.


THE BOTTOM LINE: IS SURCHARGING WORTH IT?


While surcharging may offer short- term cost savings on credit card processing fees, it also carries sig- nificant risks. Patient dissatisfaction, complicated insurance regulations and strict compliance requirements make surcharging a potentially risky strategy for dental practices. In an industry built on trust and patient loyalty, maintaining transparent and predictable pricing is often a better approach.


At Best Card, we understand the complexities involved in credit card processing. Should you determine you wish to surcharge, Best Card successfully sets up your practice for surcharging, ensuring compliance with all regulations. Our focus is on offering consistently low rates and transparent processing, whether sur- charging or using traditional pricing.


To learn more or for a cost com- parison on credit card processing for your practice, visit BestCardTeam. com or call 877-739-3952.


Phil Nieto is the President of Best Card, the endorsed credit card processor of more than 50 dental medical associations and ADA Member Advantage. He enjoys working with


thousands of dental offices to help minimize the headaches of accepting card payments by focusing on providing what the merchant services industry often lacks: innovation and integrity.


REFERENCES


1. How Much Can a Dental Practice Spend on Marketing? datamangroup.com/how-much- can-a-dental-practice-spend-on-marketing


2. Pros and Cons of Surcharging Credit Cards business.com/articles/pros-and-cons-of- surcharging-credit-cards


3. Charging a Credit Surcharge Will Cost You Customers americanexpress.com/us/small- business/openforum/articles/charging-a- credit-surcharge-will-cost-you-customers


Answering Your Questions


The MDA receives and answers a variety of questions to help our members in practice. Here are two recent ones!


QUESTION: Does a telehealth visit by a dentist constitute an examination of the patient? Per the Dental Board, it can; it depends upon the type of examination the dentist is doing. If the dentist is just performing an exam to delegate hygiene services to an RDH, then a review of the appropri- ate diagnostic data through a telehealth visit could suffice. If the dentist is trying to do a more comprehensive exam to diagnose something more complex, that might not be achievable through a telehealth visit. The exam should be appropriately thorough enough for the type of dental work that is going to be delegated, regardless of whether it is done through telehealth or more traditional means.


Applicable rules and statutes: • Section 191.1145, RSMo & Section 208.675, RSMo


QUESTION: I am inquiring about Missouri laws regarding denture adjustments. I am a clinical manager in a dental office with an in-office lab. I want to know if a lab techni- cian can, by law, make denture adjustments within the office when a patient comes in needing adjustments to the denture for comfort? I also need clarification on a doctor delegating, under direct supervision, denture adjustments to a non-licensed dental assistant who does not have basic skills certification or expanded functions.


Per the Dental Board, if a person is going to be working directly with the patient, then they would have to be EFDA certified in Removable Prosthetics — regardless of being a lab technician, dental assistant or dental hygienist. Missouri law allows a person working in a dental lab to construct or adjust a prosthetic but only when pursuant to a laboratory work order from the dentist, even if it is an in-house lab. So, if a patient has a sore spot, the dentist can send the denture to the lab tech with the accompanying laboratory work order to make the adjustment. The laws only allow a lab technician to work directly with a patient in the process of “shade verification” for a prosthetic. Once a person starts working directly with the patient to adjust because of sore spots they are working as an expanded function dental assistant and not as a lab tech. The fact that the lab is located in the dental practice does not change the requirement for the lab order or the restrictions for how lab techs work.


Applicable rules and statutes: • Section 332.071, RSMo (pages 12 and 13) • 20 CSR 2110-2.190 Shade Verification (page 13) • Section 332.098, RSMo • 20 CSR 2110-2.120 Dental Assistants (page 8), (5) Categories; 4. Prosthodontics—Fixed


ISSUE 2 | SUMMER 2025 | focus 17


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