Healthcare Merchant Services

Healthcare merchant services and health merchant services for medical practices, dental offices, physical therapy clinics, urgent care centers, and other healthcare providers. Brookside provides transparent pricing, card-on-file support, HSA/FSA card acceptance, and dedicated service to help healthcare providers control — or eliminate — processing costs. According to Federal Reserve interchange fee data, most healthcare practices overpay on processing by defaulting to flat-rate or tiered pricing.

Healthcare providers are increasingly choosing between two structures — and the right one depends on whether the practice wants to absorb processing costs or offset them entirely.

Dual Pricing: Offset Processing Cost Entirely

Dual pricing presents a cash price and a card price at the point of service — patients who pay by card cover the processing cost, patients who pay by check or cash pay the lower price. It is permitted in all 50 states and is one of the fastest-growing pricing structures in healthcare specifically because the math is compelling: a practice processing $50,000/month at 2.7% is absorbing $1,350/month in processing fees. Under dual pricing, that cost shifts to the patient at the point of transaction with full upfront disclosure. For practices that have been absorbing those costs for years, the savings are immediate and significant.

Interchange-Plus: Full Transparency, Lowest Absorbed Cost

For a medical practice merchant account that absorbs processing costs — or whose patient mix or competitive dynamics make dual pricing less practical — interchange-plus pricing is the most cost-effective structure. It separates the actual card network cost from the processor’s markup, making every transaction transparent and verifiable. A typical card mix in healthcare — standard credit cards plus HSA/FSA cards — commonly produces an effective rate 0.4–0.7% lower than tiered pricing under interchange-plus. On $50,000/month that’s $200–$350/month saved. Use the compare pricing models tool to see the difference at your volume. For why tiered and flat-rate pricing consistently cost more, see how tiered pricing works.

• Dual pricing and interchange-plus options — choose what fits your practice
• Card-on-file and recurring billing support for payment plans
• HSA and FSA card acceptance with correct MCC assignment
• Online and invoice payment capabilities
• Fast funding — often 1–2 business days
• Dedicated support with direct contact

HSA and FSA Card Acceptance

Health savings account (HSA) and flexible spending account (FSA) cards operate on the Visa, Mastercard, or Discover networks and are accepted at any merchant configured to receive them. The critical factor is your Merchant Category Code (MCC). If your MCC is incorrectly assigned, HSA and FSA cards will decline at the point of service — a frustrating experience for patients and a lost collection for your practice. Proper account configuration includes MCC verification as part of setup. See HIPAA compliance requirements from HHS.gov for the regulatory context around patient payment data.

Card-on-File and Payment Plans

Many medical practices store patient cards on file for post-service balance collection, co-pay billing, or structured payment plans. Well-configured accounts support recurring billing with appropriate interchange qualification — avoiding the higher card-not-present rates that improperly configured accounts incur on stored-credential transactions. Proper card-on-file processing requires tokenization and clear patient authorization workflows. For large invoices or recurring billing above $500, ACH payment processing can reduce costs significantly — flat fees of $0.20–$1.50 per transaction regardless of amount. See CFPB guidance on card payments for dispute context on healthcare transactions.

HIPAA Payment Processing Requirements

HIPAA governs protected health information (PHI) — including payment data when associated with a patient’s medical record. Your payment processor and gateway should be willing to sign a Business Associate Agreement (BAA) if cardholder data intersects with PHI. Brookside reviews your specific setup and compliance requirements during onboarding.

Switching Processors and Evaluating Your Current Costs

Most healthcare practices that haven’t reviewed their processing in the past two years are overpaying. Our post on interchange fees explained breaks down what each card type actually costs. The bank merchant services call post explains why your existing banking relationship is rarely the best option for healthcare payment processing. When you’re ready to move, read how to switch payment processors without losing a day of collections. If you’re unsure whether a dedicated merchant account makes sense at your volume, read do I need a merchant account. For a real example of how a healthcare practice can quietly overpay for years, Marisol Vega’s optometry practice in Tampa paid $124.99/month in PCI non-compliance fees for eighteen months — over $2,200 — before reviewing her statement and identifying the leak.

Chargebacks in Healthcare

A chargeback on a healthcare transaction is best prevented through clear patient authorization at time of service — the same authorization that ensures correct interchange qualification. Card-present chip transactions and signed authorization forms are your strongest defense documentation.

Frequently Asked Questions

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See What Your Practice Is Overpaying on Processing

Send your current statement and we’ll calculate your effective rate, determine whether dual pricing or interchange-plus is the better fit for your practice, and show the cost difference. No obligation.

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