How to read a merchant processing statement
Interchange, assessments, markup and the junk fees in between: what each line on a clinic's card processing statement means and where the money actually goes.
A card processing statement is designed to be skimmed, not read. The total looks reasonable, the deposits arrived, and the fine print goes in a drawer. Reading it once, carefully, usually pays for the hour.
The three layers of every card fee
Interchange goes to the bank that issued the patient's card. Visa and Mastercard publish these rates; they vary by card type (a rewards card costs more than a debit card) and by how the card was accepted (tapped in person costs less than typed in over the phone). Nobody can discount interchange.
Assessments go to the card networks. They're small, fixed percentages and also non-negotiable.
Processor markup is everything else, and it's the only part that varies from one provider to the next. It might appear as a percentage plus a per-transaction fee, or be blended invisibly into a single rate.
Pricing models
Interchange-plus shows interchange and assessments at cost, then a stated markup. It's the most transparent and usually the cheapest for a practice doing more than a few thousand dollars a month.
Tiered pricing sorts transactions into "qualified," "mid-qualified" and "non-qualified" buckets with different rates. The processor decides which bucket each transaction lands in. Most clinic transactions land in the expensive ones.
Flat rate charges one percentage on everything. Simple, and reasonable for low volume, but it overcharges on debit cards and in-person transactions.
Lines worth circling
- Monthly minimums, statement fees and "regulatory" or "compliance" fees, often $10–$50 each.
- PCI non-compliance fees, charged when a yearly questionnaire wasn't completed.
- Batch fees on every daily settlement.
- Equipment leases that outlast the useful life of the terminal by years.
- An early termination clause, which sets how expensive switching would be.
The one number to calculate
Divide total fees by total volume for the month. That's your effective rate. For a typical clinic with mostly in-person card payments, anything much above 3% deserves a second look.
ClinicSupply US reviews processing statements for practices as part of account setup. Send us a statement and we'll return the effective rate and the lines we'd question.