Payment processing that fits a medical practice

What medical and dental practices need

Healthcare payments rarely finish at the front desk. Patients pay a copay at check-in, owe a balance weeks later once the claim is processed, and sometimes spread a large treatment plan over months. Your payment processing has to handle all three without anyone writing a card number on an intake form.

Treatment plans and balances run large, so the percentage you pay matters more than the per-sale fee. On a $300 visit, the card a patient hands over can move your interchange cost from under 40 cents to more than $7, as the cost section below shows. That's why pricing that itemizes each card type is worth asking for.

When should a practice collect: at the visit or after insurance?

Both, for different parts of the bill. Take the copay and any old balance at check-in, when the amount is certain. Wait for the claim before you charge deductibles and coinsurance, because a guess collected up front tends to come back as a refund. Dental offices add a third moment: the deposit when a crown or bridge goes to the lab.

Visa treats a payment for services you'll provide later as an advance payment, so write the deposit terms down before you charge: what it covers, when the rest is due, and what's refundable once lab work starts. For patients paying without insurance, CMS says they have the right to a good faith estimate of the cost and can dispute a bill that lands at least $400 above it. Base any deposit on that estimate, not a round number.

Will FSA and HRA cards work at your front desk?

Usually, as long as your account carries a health care merchant category code. The IRS ruling behind health FSA and HRA debit cards describes cards limited to merchants with health care codes, and names physicians, dentists, pharmacies, vision care offices and hospitals among them. Visa's Merchant Data Standards Manual lists 8021 for dentists and orthodontists. When a benefit card declines, check the code on your statement before you blame the card, and hand out itemized receipts so the plan can see what the charge was for.

Can a practice add a credit card surcharge?

In most US states, on credit cards only, though we'd think twice. Visa caps a US surcharge at your merchant discount rate or 3%, whichever is lower, and wants 30 days' notice to your acquirer. Mastercard caps it at your average effective merchant discount rate or 4%, whichever is lower, and neither network allows a surcharge on debit or prepaid cards. Maine bans surcharges on credit and debit cards, and Massachusetts bars sellers from surcharging customers who pay by credit card.

In Canada, Visa caps a credit card surcharge at 2.4% or your merchant discount rate, whichever is lower, and Quebec's consumer protection office says merchants there can't charge any fee for paying by card. On a $300 visit, 3% is $9, added to a bill the patient didn't choose to run up. If you go ahead anyway, Clearo's surcharging program covers compliance, disclosure and setup, and our page on surcharging rules by state covers the rest. These rules are current as of October 2026; confirm them with the linked sources before you add a fee.

How Clearo works with practices

Clearo is an authorized reseller of front-desk terminals from partners such as Clover and Helcim, and our virtual terminal takes phone payments and sends invoices, payment links and recurring charges. Every practice gets interchange-plus pricing, a dedicated rep, and no long-term contract or cancellation fee. A free statement review of one recent statement shows your effective rate and which card categories drive it. Our guides to medical credit card processing and dental credit card processing go deeper.