One of the advantages of using a full-service EHR like SimplePractice or TherapyNotes is that the payment processing system is already integrated into it, so you can collect payments easily without having to add any extra pieces on.
But, as with all the other features these EHRs are providing, you’re paying for the convenience. SimplePractice, for example, uses Stripe as their credit processor; their rate is 2.95% + $0.30 for each successful transaction. This is not a terrible rate, but it’s certainly not the best out there. Square’s credit processing fee, for example, is 2.6% + $0.10 per transaction. That’s less.
But not a whole lot less. Let’s take a quick, made-up example of a month in which you have 100 appointments at $100 each (=$10,000 revenue). That comes out to $325 with SimplePractice and $270 with Square (I did the math for you. You’re welcome). So you made $10,000 that month, and you paid $55 you didn’t need to. Okay, not tragic.
What’s the alternative?
If you are going with Google Workspace (or some other more stripped-down approach) as your EHR, you do need to DIY on the payment processing.
Fear not. It’s not that hard.
PayPal, for one, is an option. (Note that, strictly speaking, you need to have a business account with them to do this – the no-fee “pay your friend” option is against their terms of service if you’re running a business. No judgment on what you decide to do – just giving you the facts.)
PayPal is HIPAA compliant, but only for accepting payments, not for things like sending invoices (since they don’t offer a BAA), so that’s a bit of a limitation. (HIPAA doesn’t apply to banking services and similar payment systems – apparently processing a payment falls under that exemption, but sending an invoice does not. 🤷 – Don’t shoot the messenger.)
Apps like Venmo and CashPay also have clauses in their terms of service that state you cannot use them for business payments unless you open a business account which (surprise!) requires you to pay a fee on transactions. Zelle is a payment network that is tied to your bank, so you'd have to ask them whether you can use it for business (assuming you want to comply with their terms). Some allow it and some don't.
IvyPay is a HIPAA-secure payment system designed specifically for mental health practitioners, so that’s nice. They do offer a BAA for any parts of their system that need the HIPAA coverage. Their rate is 2.75%, which is also decent.
Okay, but what do YOU use for payments?
Great question! Glad you asked.
The payment solution I use is to go straight to a credit card processing company, so I can get the lowest rate. Someone connected me with a place called Commission Buddies a few years ago, and I was quickly smitten. Nathan is my guy over there, and he offered to beat whatever rate I had before; he did so handily. (I believe he will make you the same offer, whatever you’re using now.) He also guarantees never to raise the rate.
That’s only part of the reason I’m smitten, though. These guys provide the best customer service I have ever experienced, anywhere. Seriously. When problems have come up with payment stuff, whether or not Nathan and his crew have anything to do with it, Nathan is ready in a moment to help solve the problem. He has answered my texts at 10 PM to help deal with an issue.
When there is some other company involved (like the credit card company itself), he will call them for me, wait on hold, explain the problem to the rep, then patch me in.
Why can’t more companies be like this?
Needless to say, I wholeheartedly recommend Nathan and his Commission Buddies. (It is so named because in addition to beating your current rate, they split the profit with you from whatever commission they make from your credit processing. !!!)
Note that I do get a referral kickback if you sign up with them. I would totally recommend them even if I didn’t. No, really.
One more point about Commission Buddies, in regards to convenience: they will set up a payment portal on your website for you, so you don’t actually have to DIY that part because they will take care of that, and then they’ll walk you through how to use the whole thing too.
As with many parts of the Workspace-EHR approach, it’s not as ready-and-waiting for you as with the other players in the field. But this piece of the puzzle doesn’t have to be a beast, and you can get it for cheaper, too. (By the way, even if you use a different EHR system, you can still use any of the above cheaper methods to process payments and save some money.)
For more info or to get set up with Commission Buddies, reach out to Nathan at ncouto@commbuds.com!
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