Bank-to-bank ACH and eCheck for high-balance patient accounts — 0.5–1.0% rates, 1–3 business-day settlement, and dramatically lower processing cost than card on a $2,000 balance.
When does ACH beat card for patient payments?
Anytime the balance is above $500 or the patient is on a multi-month payment plan. On a $2,000 balance, card processing costs about $58; ACH costs $5–15. Across a year of plan installments the savings compound into real margin.
How are ACH returns handled for patient balances?
NACHA return codes (R01 insufficient funds, R10 unauthorized) trigger automatic retry rules — typically two retries spaced 5 business days apart. Unauthorized returns surface to your billing team for outreach; insufficient-funds returns auto-recover at a 60–70% rate.
Does ACH work with HSA bank accounts?
Yes. HSA-linked checking accounts ACH the same as any other bank account, but our routing tags the transaction as a qualified medical expense so the patient's HSA administrator does not require additional substantiation.
How does this pair with payment plans?
Recurring payment plans debited via ACH cost a fraction of card-funded plans. Most practices default plans above 6 months to ACH and keep card as the fallback rail.
Frequently asked questions
How fast can you get approved?
Most healthcare practices are approved within 24 hours of complete application submission. Specialty MIDs (dental DSO, behavioral health groups, DME) may take 48–72 hours while underwriting reviews trailing statements and licensure.
What does it cost?
Interchange-plus pricing — typically 2.4% + $0.10 per card transaction with no setup fee and no monthly minimum. ACH is 0.5–1.0%. You see interchange cost, assessments, and our markup on a single itemized statement.
Is the platform HIPAA-compliant?
Yes. We sign a BAA, tokenize all card and bank data before it touches your systems, and segregate PHI from payment metadata. EHR / PMS integrations move only the minimum necessary data for posting.