Healthcare
Patient payments by card and bank, inside your practice software
Payment processing for healthcare software lets patients pay balances by card or from a US bank account, and the plans your software schedules can run as ACH bank payments under the ACH authorization rules. BrainMerchant processes card and ACH payments for software platforms.
Riverside Family DentalStatement #3310
Amount due$240.00
- Pay by bankACH from a checking or savings account
- Pay by cardCredit card
Pay $240.00
Card and ACH payments processed by BrainMerchant
Patient payments
Where patients pay in your software
Patients pay at several points in a course of care, not only at the front desk. Whether you build medical billing software or dental practice software, these are the places where card and bank options fit.
Balances after insurance
Once a claim is processed, the patient owes the part insurance did not cover. Your software can show that amount with card and bank options, so staff do not have to chase it by phone.
Payment plans your software schedules
Larger balances are often split into installments. By ACH, each scheduled debit needs the authorization the rules require.
Deposits for planned treatment
Treatment plans often start with a deposit. Patients can put it on a card or pay it from a bank account, and your software can record it against the plan.
Online statements in the patient portal
A pay option on the emailed statement or in the portal lets patients pay from home, instead of mailing a check or waiting for the next visit.
Bank payments authorized by phone
Under the ACH rules, a consumer debit authorized orally over the phone is a TEL entry. TEL has its own recording and written-notice requirements, so check them before your software takes bank payments by phone.
Memberships and wellness plans
Some practices sell in-house membership or wellness plans paid monthly. By ACH, those debits run under a recurring authorization the patient signs or similarly authenticates.
Payment plans
Payment plans and the rules behind them
The ACH rules allow recurring debits with a signed or similarly authenticated authorization and a copy for the payer. Your software sets the schedule; talk to us about how scheduled payments would work with BrainMerchant.
Before you build plan sign-up, read our guide to ACH authorization requirements. These are the points that matter most for patient plans:
- Online sign-up uses WEB. WEB is the SEC code for consumer debits authorized over the internet or a wireless network.
- Unauthorized debits have a 60-day return window. They can be returned for 60 calendar days after the settlement date, with a written statement from the patient to their bank.
- Card disputes run on their own clock. Under Visa’s rules, the card issuer generally has 120 calendar days from the transaction processing date to process a dispute.
- Card plans are a provider question. If patients will pay installments by card, ask your provider how repeat card payments work.
Patient payment plansWhat each installment depends on
- AuthorizationACH: signed or similarly authenticated, with a copy
- ScheduleSet by your software
- ReturnsUnauthorized ACH debits: 60 calendar days
- DisputesVisa: generally 120 days from processing
Card vs ACH
Card or ACH for patient payments
General guidance for patient payment processing, not rules: what fits best depends on the amount, how often the patient pays and how the practices you serve work.
| Payment | Card | ACH |
|---|---|---|
| Copay at booking | Suits small amounts; the issuer approves or declines on the spot | Works with the patient’s authorization; funds settle between banks afterward |
| Balance after insurance | Lets patients pay from a statement or the portal with the card they carry | Lets patients pay from a checking or savings account instead |
| Payment plan | Depends on your provider; see payment plans | Recurring debits with the authorization the rules require |
| Membership plan | Depends on your provider; see payment plans | Recurring debits under a signed or similarly authenticated authorization |
| Large treatment balance | Costs for the receiving business are typically a percentage of the payment | Cost benchmarks are per payment rather than a share of the amount; provider pricing varies |
Keep card data out of clinical records
The card industry’s data security standard, PCI DSS, applies to anyone who stores, processes or transmits cardholder data, or who could affect the security of the environment where it lives. That includes SaaS platforms. So design your software so card numbers never end up in chart notes, intake forms or free-text fields.
Tokenization swaps the card number for a substitute value. It can shrink the part of your system in scope, but it does not remove PCI DSS obligations. Read PCI compliance for SaaS platforms, then tell us your requirements when we talk.
In context
Healthcare payments in context
Context from insurers, the card networks and consumer surveys.
78%
Electronic insurer payments are normal in medicine
The 2025 CAQH Index puts electronic (EFT/ACH) adoption for claim payments at about 78% for medical practices and 33% for dental practices. These are payments from insurers to providers, not patient payments.
4
Medical is a special payment facilitator vertical
Visa and Mastercard exempt four medical merchant category codes (8011, 8050, 8062 and 8099) from their payment facilitator sub-merchant volume thresholds. Dental, veterinary and child care are not on either network’s list.
37%
Patients pay remotely
In the Federal Reserve’s consumer payments diary, about 37% of consumer payments in 2025 were remote rather than in person. Statements and portals with a pay option fit that habit.
Questions
Questions about payment processing for healthcare software
Short answers for teams building billing and practice software.
Can patients pay from their bank account?
Under the ACH rules, yes, with the patient’s authorization. When the patient authorizes online, the debit is a WEB entry. BrainMerchant processes card and ACH payments for software platforms, and our ACH side is for US bank accounts. See ACH payment processing for platforms.
Can our software offer patient payment plans?
Under the ACH rules, yes, once the patient authorizes the plan’s debits. When a patient signs up for a plan online, those debits are WEB entries, the SEC code for consumer debits authorized over the internet or a wireless network. Build for returns too: an unauthorized debit from a patient’s account can be returned for 60 calendar days after the settlement date. Talk to us about how scheduled payments would work with BrainMerchant.
How do card and ACH costs compare?
In AFP’s 2022 survey, cited by the Cleveland Fed in 2026, the median cost of an ACH payment was $0.25 to $0.50 for each side, while a business receiving a credit card payment paid a median of 2.0% to 2.5% of the payment. Those medians come from business payments, not patient payments, and your costs depend on your provider’s pricing. Our guide to ACH processing fees explains what drives the cost of a bank payment.
Our software serves dental or veterinary practices. Where do we start?
Tell us about your platform and how practices collect today.
Talk to BrainMerchant
Give patients card and bank payment options in your software
Share how your practice management software handles statements, payment plans and the patient portal, and we’ll walk you through what adding card and ACH processing with BrainMerchant looks like.