By Patrick Creaghshutterstock_108493910

As providers process historically high volumes of patient revenue, the technology facilitating these transactions becomes that much more important.

Choosing a payment processing partner is no longer a casual decision. The higher your payments volume, the more your decision matters. Even if you are a stand-alone practice, your payment technology reflects your commitment to data security and patient satisfaction (or lack thereof). Patients expect that you will accept credit card transactions on EMV-compliant terminals as well as cash and HSA/FSA cards.

While some healthcare providers choose to outsource their selection to a payments company, this often conceals hidden fees and charges in the complexity of multiple contracts. If you aren’t careful, you may find yourself paying fees and surcharges that have essentially been invented by the payments company.

Checking For Hidden Charges

To evaluate your processing contract, you need a copy of a recent processing statement. Most of the charges listed below will be included on this statement if they exist. If you find one, contact your processor for more information or consider reevaluating your partnership.

For more information about determining your true cost to process payments, check out our free e-book, The Healthcare Provider’s Guide to Selecting a Payment Processor.

Hidden Charges to Watch Out For

As a start, here are four fees to look for on your next processing statement:

Authorization Fees– In certain processing contracts, an authorization fee is charged every time a credit card transaction is made; the amount depends on whether or not the card is present (and swiped) at the time of the transaction. This is separate from a transaction fee, which is the standard amount charged per transaction.

Gateway Fees– When your patients pay online, your payment processor may charge a payment gateway fee. This is because unless you use a vendor that consolidates all payment options, you will have to pay fees to a separate payments gateway in addition to the standard credit card association fees (known as interchange fees).

PCI Compliance Fees– Some merchant account providers will charge PCI compliance fees, to ensure they remain PCI-compliant. Given that PCI compliance is absolutely necessary, this is just an extra charge on your bill. You should not partner with any payments company that is not PCI compliant.

Return/Refund Fees– When you have to adjust or refund patient transactions for any reason, some companies will charge you a fee to send the money back.


These fees are designed to confuse you and obscure your true cost to process revenue and there are more than just four types. While your ‘rate’ may technically be lower, always make sure to check your contract for hidden charges that may cost you thousands or even tens of thousands more.

The best way to determine your true rate is to divide the total amount being charged by your payments company by the total amount processed. If it’s higher than you expect, you may want to consider switching vendors.

Schedule a demo to learn how Patientco can help you increase patient revenue and process patient payments more efficiently.