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Taking Bank ACH instead of credit cards



  • Kathleen Burke

    I’d like to preface my response by disclosing that I run a therapy practice with ten clinicians and a part-time biller. In our practice, I’ve accepted that making phone calls to clients to get updated credit cards is part of doing business. Therapy practices are unusual in that they provide recurring healthcare services that last weeks, months, or even years. For clients with copays, coinsurance, or deductibles, that means multiple transactions that occur over long periods of time. Invariably, you will have trouble getting paid by someone.

    Another issue is that most therapy practices don't have a receptionist to collect cash or a check from a client at the time of the session. We have found that the therapists working in our practice are not very diligent when it comes to collecting money at the time of service. While they don’t mind occasionally collecting cash or a check, they like that most of their clients prefer using a credit card so they don’t have to bother with a financial transaction. There is also the issue of telehealth, where you need to have a credit card because the client is not seen in the office.

    As to your original idea of having ACH, in a therapy practice you are not talking about a business to business transaction. You would be asking a client in therapy to provide you with bank account and routing numbers. Think about how intrusive that is, and the perception your client might have about their relationship with their therapist. Can you imagine walking into a doctor's office and being told, "We don't really want to take your credit card. We'd prefer you give us your bank account number and we'll just take your payment right out of your account?"

    You could always try using something like, where you can get hardware that takes credit cards on sight. Then you would know in the presence of the client if the card was declined and ask for another form of payment. We don’t bother with this because then our therapists would have to be the ones directly accepting the payments at every session. We’d rather have our biller handle that.

    Occasionally, cards will be declined, and for a variety of reasons. Even so, I think more than 99% of our credit card transactions go through without a hitch. When cards are declined, and a client won’t respond to our biller's phone calls, we involve the therapist. A client who won’t respond to our biller will usually respond to their therapist with whom they have a relationship. Our therapists are okay with this because it is not very often that we can’t collect money from a client, and, in our practice, the therapist doesn't get paid unless the money is collected.

    Another reason we also involve the therapist is that if a client is having financial problems, or is not paying their bills, then that is certainly a therapy issue in and of itself that should probably be discussed between client and therapist.

    Hope that at least some of that was helpful. Just my two cents.

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  • Phillip Dacus

    All good points. Thank you for your responce

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