Patient Financing and Card Fees: Count Them as Costs

Card processors and patient financing programs make it easy for clients to pay. They also take a share of every transaction, and because that share is usually deducted before the money reaches your bank, it is easy to never see it as a cost.

How fees disappear

If a client pays $1,000 and the processor deposits $970, many clinics record the $970 deposit as revenue. The $30 fee is never recorded anywhere. Revenue is understated, and a real cost is invisible.

Record them properly

Record the full $1,000 as revenue and the $30 as a merchant or financing fee expense. Most accounting software and POS integrations can do this automatically if set up correctly.

Why it matters

• Accurate margins: fees reduce the contribution of every treatment. For high-ticket services paid through financing programs, the fee can be a meaningful share of the price.
• Reconciliation: recording gross sales and separate fees makes it much easier to match POS sales to bank deposits.
• Negotiation: once you see the total paid in fees each month, you can compare processors and negotiate.

Financing programs

Patient financing can help clients afford larger treatments, but programs that charge the clinic a percentage of the sale are a real cost. Track financing fees separately and check which services are most often financed. Consider whether pricing for those services should account for the fee.

Questions to ask each quarter

• What did we pay in card fees and financing fees in total?
• What is that as a share of revenue?
• Which payment methods cost the most?
• Are there processor fees we are paying that we do not understand?

Any surcharge or fee passed on to clients must follow card network rules and state law, so check before introducing one.