Running a telemedicine business is hard enough without getting paid headaches.
Virtual healthcare has boomed over the last few years. More patients are seeking virtual care. More providers are offering it. But there’s a catch…
Regulations surrounding telemedicine payment solutions change constantly. Keeping up is crucial or a business risks losing everything from its revenue to its very ability to process payments.
What You’ll Learn:
- Why Telemedicine Payments Are So Complicated
- The Biggest Regulatory Hurdles Right Now
- How Payment Parity Laws Impact Your Business
- Finding the Right Payment Partner
Why Telemedicine Payments Are So Complicated
Telemedicine payment solutions require a unique approach because the industry functions differently than traditional healthcare.
Think about it…
Every transaction is online. There is no card swipe at a front desk. No signature on a receipt. In other words, every payment is a “card-not-present” transaction.
And that’s where it gets complicated.
Card-not-present transactions present a higher risk of fraud. Banks and payment processors know this. It’s why telemedicine businesses are considered “high risk” as a result.
This high-risk classification causes very real problems for telemedicine providers trying to accept payments. Traditional banks often won’t do business with them. This is why specialized payment partners like 2Accept offer dedicated telemedicine merchant accounts designed for healthcare providers.
Fraud risk is just one part of the story…
HIPAA compliance is another issue. Telemedicine patient data must be protected at every transaction. Payment processing needs to have security measures in place regular merchant accounts don’t.
Chargebacks are another headache.
Patients file chargebacks on telemedicine charges. They sometimes have unrealistic expectations. They sign up for a subscription and then forget they did it. In any case, chargebacks eat into revenue and can even result in a provider losing their ability to process payments.
The Biggest Regulatory Hurdles Right Now
The regulatory landscape for telemedicine payment processing is always shifting.
The pandemic saw a loosening of telehealth regulation to enable wider access to virtual care. However, those temporary measures are expiring or otherwise changing. According to telehealth.org, CMS has extended Medicare telehealth flexibilities through Sept. 2025, but the future beyond that is uncertain.
Provider uncertainty is one problem this creates.
Providers don’t know how to plan long-term when they don’t know what the rules will be next month.
Here are the main regulatory hurdles to payment processing right now:
- State licensing requirements – Providers typically need to be licensed in both the state they’re in and the patient’s state
- Controlled substance prescribing rules – DEA regulations for telehealth prescribing have kept changing
- Reimbursement variations – Every payer has slightly different rules around what they will cover
- Data security mandates – HIPAA requirements apply to telemedicine payment processing
DEA has extended telemedicine prescribing flexibilities to December 2025. But not all final rules are set in stone. Providers don’t know what the long-term policies will be.
This limbo situation makes it difficult to build a stable payment processing system.
How Payment Parity Laws Impact Your Business
Payment parity is one of the biggest telemedicine regulatory issues out there.
Payment parity laws require insurers to reimburse telehealth services at the same level as in-person visits.
Without parity, telemedicine businesses might receive less pay for delivering the same care via telehealth. That drives down the bottom line.
The good news is that more states are enacting payment parity laws.
Currently, 23 states have implemented parity laws and an additional five have partial requirements. But 22 states still have no payment parity requirements.
This results in a confusing patchwork of regulations.
Telemedicine providers who serve patients in multiple states must keep track of different reimbursement rules for each one. It’s a compliance headache that requires significant attention.
Payment parity also impacts how telemedicine businesses price services. In states without parity requirements, providers may need to adjust their fees or risk losing money on virtual visits.
Finding the Right Payment Partner
The choice of payment processor can make or break a telemedicine business.
Not every merchant account provider is healthcare-friendly. Not every processor can handle special compliance requirements. And certainly not every bank will do business with a “high-risk” industry.
Here’s what telemedicine providers should look for in a payment partner:
- HIPAA-compliant processing – This is essential. Any payment processing handling healthcare transactions must have data security measures in place that meet federal standards
- Experience with high-risk accounts – Processors that focus on telemedicine are used to the chargeback risk and regulatory complexities. They will not freeze an account over industry norms
- Fraud prevention tools – A good processor offers top-notch fraud detection capabilities. This helps the business and its patients from bad actors
- Recurring billing options – Many telemedicine services use subscription models. The payment system needs to handle auto-billing smoothly
- Integration capabilities – Payment processing should work seamlessly with existing telemedicine platforms and EHRs
The wrong payment partner can shut a thriving business down in a day. Major processors may terminate accounts without warning once they decide the risk level is too high.
Specialized telemedicine payment companies build relationships with banks that understand the industry. They partner with financial institutions that get it. They underwrite accounts carefully so there are no surprises later.
Staying Compliant While Growing
Compliance is an ongoing process.
Telemedicine businesses must remain vigilant of regulatory changes. State laws change. Federal policies shift. Just because something is compliant one day doesn’t mean it will be the next.
Here’s a simple compliance strategy:
- Subscribe to industry newsletters and regulatory bulletins
- Partner with payment solutions who monitor regulatory changes
- Build relationships with healthcare attorneys who understand telehealth
- Document everything. Document everything related to payment processing and patient consent
The telemedicine businesses that thrive are the ones that make compliance a top priority. They never stop thinking about it.
The Bottom Line
Telemedicine payment solutions come with unique regulatory challenges. But they’re not insurmountable.
The key is understanding the playing field. High-risk classification. HIPAA rules. State licensing. Payer reimbursement variations. These all play into how a telemedicine business will generate revenue.
Finding the right payment partner is critical. Specialists who understand healthcare can help providers prevent frozen accounts, manage chargebacks and maintain compliance as regulations shift.
The telemedicine industry is not going to slow down anytime soon. Patient demand for virtual care is only increasing. Providers who figure out how to solve payment challenges now will be positioned to capture more growth.
Don’t let regulatory complexity stop the business from moving forward. Get the proper systems in place and focus on what matters most… delivering the best care possible to the patients that need it.
