Practice Management Software and Credit Card Processing

Unfortunately, many practice management systems lock you in to one or two processors, eliminating your competitive leverage to negotiate low pricing for your merchant account. So, what are your options? You can either resign yourself to continually watching your pricing and fighting off rate hikes, or you can consider a “non-integrated” solution.

In this article, I’ll explain the differences between integrated and non-integrated processing, go over pros and cons, and show you how to find out your real costs for credit card processing.

What is practice management software?

Practice management software is software designed to help a medical practice conduct business more efficiently. Depending on the software, it may include features such as patient scheduling, charting, payment processing, insurance claim tracking, and more.

Any branch of medicine and health can benefit from practice management software, including general and specialist doctors, dentists, surgeons, and veterinarians.

This article will focus on one specific feature: payment acceptance when customers want to use credit cards.

Taking Payments with Practice Management Software

There are two ways to take card payments when you use practice management software. One is “integrated” processing, which is what it sounds like: the payment processing will integrate with your practice management system.

The second is “non-integrated” processing, meaning the payment solution doesn’t integrate with the software. Let’s take a closer look at what each option entails.

Integrated Payment Processing

As noted above, integrated payment processing means that you can use your practice management system to accept a card payment from a patient. The payment will be recorded for you in the patient’s file. You can also set up a secure card storage “vault” if you want to keep credit cards on file for future charges.

Pros of Integrated Processing

By far the biggest benefit to integrated processing is that you’ll do everything in one place. Not only will you use the practice management software for functions like charting and scheduling, you’ll also use it for accepting credit cards. When you take a card payment, your software will automatically record it to the patient’s file in the system.

Cons of Integrated Processing

The biggest drawback with payment processing integrated with your practice management solution is typically cost. Many popular practice management systems restrict your choice of processor for integrated processing. If that’s the case, you have no competitive leverage to negotiate costs – the processor can essentially hold you hostage, requiring that you pay the rates they set if you want integrated processing.

With integrated processing, rates are typically higher and the processor usually pays a kickback to the practice management system in exchange for exclusivity.

Non-Integrated Payment Processing

If your practice management solution limits you to one or two integrated processors, you can still choose a different processor. It just means that you won’t use the built-in processing. With non-integrated processing, you won’t initiate or complete the payment through your practice management system. Instead, you’ll use a countertop credit card machine (or a virtual terminal on your computer) in order to accept the payment.

Pros of Non-Integrated Processing

Non-integrated processing allows for lower rates. When you’re not “locked in” to one or two processing companies, you can shop around for the best possible pricing. You can even take advantage of wholesale credit card processing club memberships (like CardFellow’s) to get exclusive members-only rates for your merchant account.

For businesses that don’t want to needlessly pay more than they have to for credit card processing, non-integrated solutions are a great option.

Cons of Non-Integrated Processing

The biggest downside to non-integrated processing is that the payments will not automatically post to the patient’s file in your practice management system. You’ll need to determine if that’s a dealbreaker for your practice.

You can still manually record the payment. In fact, CardFellow has helped many practices that have determined that the staff time to record a non-integrated payment is minimal and that the savings on processing fees more than justify it. However, it will be a practice-specific decision.

Need help determining if the savings are worth considering non-integrated processing? Fill out our basic business profile and give us a call for assistance. We’ll give you the real numbers and our expert opinion on whether it’s worth considering a switch.

Credit Cards on File (CCoF) for Medical Practices

When it comes to integrated vs. non-integrated processing, many practices wonder: Will I still be able to keep cards on file if I don’t use the payment solution in the practice management system?

The good news is that you’ll still be able to keep cards on file with non-integrated processing. The bad news is that it will be a different screen / it won’t be initiated from the practice management software. That means that like other types of payments, the transaction won’t automatically record in the patient’s file.

However, you can manually record the payment if it’s important to have that info in the patient’s file.

Card Storage Vault

In order to keep cards on file without using the practice management system, you’ll use the “card storage vault” from your chosen credit card processor. The processor will set you up with what’s called a virtual terminal – essentially, a secure web portal where you’ll actually process the payment. The card vault and virtual terminal work together so that you can keep cards on file securely but still access them quickly to make a patient payment.

Are non-integrated processors HIPAA compliant?

Practices are understandably concerned with ensuring HIPAA compliance. We’re often asked if particular processors are HIPAA compliant.

The good news is that basic credit card processing functions are actually outside of HIPAA scope. When you work with a credit card processor, they’re considered to perform “normal banking functions” on behalf of the customer making the payment, and thus not subject to HIPAA regulations.

However, that changes if your processor performs any additional functions for you, like invoicing your patients or managing accounting. For non-integrated processing, the processor will not perform back office functions such as accounting.

Read more about HIPAA compliant credit card processing.

Now that I’ve covered the difference between integrated and non-integrated processing, let’s look at some of the major practice management systems available today and whether they restrict your choice of processor.

Note that CardFellow does not receive money from any of these systems and are not affiliated with these companies.

General Medicine

Common practice management software that doctors’ offices use includes:

  • Kareo
  • CareCloud
  • Advanced Data Systems’s Medics Premier

Kareo Credit Card Processing


Popular solution Kareo unfortunately limits your choice of processors. The company confirmed that it only offers integration with Stripe at this time. For new practices, that may not be a bad fit, as Stripe’s flat rate pricing model is often a good idea when you’re taking a few thousand dollars or less per month in cards. But for larger or more established practices, Stripe’s flat rate pricing is quite high.

If you’re using or considering Kareo, it’s worth doing the math to see how much you can save with a different, non-integrated, credit card processor. Contact CardFellow if you need help determining the possible savings.

CareCloud Credit Card Processing


Unfortunately, Kareo isn’t the only popular practice management solution that limits your choice of processors. CareCloud only offers integrated processing with payments giant First Data. While any processor has the ability to offer good pricing, it’s less common to see the most competitive rates when you use an integrated option, as the processor typically has to pay the practice management system a fee, thus raising your costs.

Advanced Data Systems’s Medics Premier Credit Card Processing


Once again, this solution limits your options. Medics Premier, the practice management solution from Advanced Data Systems, integrates only with TSYS for credit card processing. It’s worth comparing non-integrated options to determine the possible savings.

Dental Practice Management Software

Some of the most popular dental practice management software includes:

  • Dentrix
  • Carestream Dental
  • Open Dental

Dentrix Credit Card Processing


The 800-lb gorilla of dental practice management systems, Dentrix is unfortunately also one of the most restrictive when it comes to payment processing. The company introduced its own payment solution – Dentrix Pay – which it heavily pushes. Other than that solution, the only other integrated option is PowerPay. In our experience reviewing dental practice merchant statements from practices using Dentrix, the rates are not particularly competitive.

If you’re using Dentrix, it’s a good idea to check what you could be paying for non-integrated processing. The savings may be great enough to warrant a switch. Need help evaluating? See the rates your practice could be paying. It’s free, custom to your practice, and there’s no obligation. Click to get rates for dental practices and then send us a statement for help comparing the options.

Carestream Dental Credit Card Processing


Another solution that restricts processors, Carestream Dental offers credit card processing integration with Total System Services (TSYS.) While it may be possible to secure good pricing, the lack of options does remove your competitive leverage. If you use (or are considering using) Carestream Dental, be sure to take a look at what it would cost to use a non-integrated processor.

Open Dental Credit Card Processing


Open Dental also restricts your choice of processors. You can pick between X-Charge, PayConnect, or PaySimple. The company’s website unequivocally states that it does not intend to pursue other processing partnerships. Unfortunately for you, that means less competitive leverage for getting low pricing. You may want to consider using non-integrated processing.

Optometry Practice Management Software

Popular practice management software for optometrists includes:

  • Crystal PM
  • EyeCloud
  • MedicsPM for Optometry

Crystal PM Credit Card Processing


As a practice management solution specifically geared toward optometrists, Crystal PM includes features not found in general medicine software, such as glasses frame inventory management. Unfortunately, like many other solutions, it also limits your choice of processor. Crystal PM lists TSYS as an integrated partner for credit card processing.

EyeCloud Pro Credit Card Processing


As the name implies, EyeCloud Pro is practice management software specifically for optometrists and eyeglass retailers. However, it’s an unusual solution in that it doesn’t have a built-in processing option, according to the company.

You can still use EyeCloud Pro and take credit cards; it will just be a non-integrated solution using a countertop credit card machine or virtual terminal.

Advanced Data’s MedicsPM for Optometry Credit Card Processing


Another offering from Advanced Data Systems, MedicsPM for Optometry is the practice management solution the company offers specifically for optometrists. Unfortunately, it does restrict processors. You’ll need to work with TSYS if you want to utilize the integrated processing option.

Determining Processor Compatibility

If your practice management software isn’t listed here, start by contacting the company that makes the software. Ask them which processor(s) you can use with their system. If they only work with one or two processors, you’ll need to determine if you want to pay the costs for the convenience of integrated processing or if you’d rather use non-integrated processing to save on transaction fees.

The integrated processor said they’ll match rates, should I just do that?

Offering to beat or match credit card rates is a very common sales tactic in credit card processing. Unfortunately, it rarely works out the way you’re expecting. “Rate matches” tend to be for a short period of time – just long enough to get you to forget about your processing rates and stop paying close attention.

If integrated processing is a must for your practice, it’s worth negotiating for the lowest markup possible, not on “matching rates.”

Do I have to use practice management software to take payments?

Nope! In fact, many small practices choose not to use practice management software, either due to expense, staff preference, or other reasons.

If you choose to forego practice management software, you can still accept credit cards (and HSA / FSA cards) by opening a merchant account with the processor of your choice. You can follow the same procedures for getting quotes and choosing a processor as you would for choosing a non-integrated solution. Essentially, without a practice management system, you’ll simply use a countertop credit card machine or a virtual terminal to accept card payments.

If possible, it’s a good idea to use a countertop terminal to swipe cards. Swiped transactions are less costly than “keyed” transactions or payments made with cards on file.

Need to see rates and fees to accept credit cards without a practice management system? We’ve got you covered. Fill out some basic information about your practice (don’t worry, we keep your info private) and you’ll get quotes instantly from multiple processors so you can make an informed decision.

It’s free and there’s no obligation. Try it now!

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