by Matt Rej
Getting paid is obviously a necessity for any chiropractic business. And the ability to cleanly match payments with patient records while reconciling everything from the same platform as your EHR software definitely makes things easier.
ChiroFusion promotes its ability to simplify this with its integrated payment processing capabilities.
But just because you’re using ChiroFusion to manage scheduling, health records, and claims, it doesn’t mean you have to use their integrated payment solution.
While I won’t argue with its convenience, the tradeoff is cost. And the added expense isn’t a no-brainer for every practice when you crunch the numbers.
Who Actually Processes Payments Through ChiroFusion
First, let me clarify exactly what it means to get integrated payments through ChiroFusion. Because that answer isn’t obvious to the average chiropractor who doesn’t have a background in payments.
There are different names being thrown around, which adds to the confusion. But here’s what you need to know:
OpenEdge (Global Payments) is the only credit card processor that officially integrates with the software. This can sometimes be confusing because ChiroFusion uses OpenEdge in some documentation but Global Payments in others, but it’s the same company.
Your merchant agreement and processing contract goes directly through Global Payments. ChiroFusion doesn’t process your payments or set any of your pricing associated with credit card processing. All they do is support the API that allows this integration.
MailMyStatements offers a separate service if you want statements printed and mailed out to your patients for you. But they don’t do any payment processing. When a patient pays their bill online from a mailed statement, the payments still get processed by Global Payments.
Helcim is a PayFac that advertises an integration with ChiroFusion. However, this is a browser extension and not a direct API integration. Helcim even explicitly says that the extension is not officially sponsored, endorsed, or authorized by ChiroFusion. It just automates Helcim payment data into the software through the browser app.
Now that we’ve got the basics out of the way, let’s dive a little deeper into all of this so you can make the right decision for your practice.
Can You Use Your Own Credit Card Processor With ChiroFusion?
Yes, you can keep your current payment processor and use ChiroFusion. But your existing provider may not necessarily integrate with the software.
Unless you’re already using OpenEdge or Global Payments, then your current processor probably can’t directly sync with ChiroFusion through an API.
But as you can see with the Helcim setup, it’s possible your processor may be able to come up with some type of creative workaround to help automate your payment data with the patient records in your practice management software. So it’s worth asking them about.
Otherwise, you can keep your payment processing separate from ChiroFusion. And this will likely be the cheapest long-term option for you.
Integrated credit card processing is always going to be marked up higher than standalone processing, which means you’ll pay more on every single transaction indefinitely.
Switching processors is rarely more cost-effective in any scenario. But switching to an integrated solution that’s run through Global Payments: that I can practically guarantee will be significantly more expensive than what you’re currently paying.
OpenEdge vs. Helcim
Looking directly at the only two processors that publicly integrate with ChiroFusion, they’re very different. And if you’re starting a new practice and need to get set up with payment processing for the first time, it’s logical to want a solution that integrates with your preferred EHR software.
Let’s take a closer look at each.
OpenEdge (Global Payments)
OpenEdge is a division of Global Payments that focuses on payment software, embedded payments, and third-party integrations (which is part of the umbrella that ChiroFusion falls under). But the names OpenEdge and Global Payments are essentially synonymous from your perspective.
It’s a traditional processor, meaning they do everything end-to-end, including the backend acquiring. That’s normally a good thing because it means you have direct access to the acquiring bank without a middleman.
But unfortunately, Global and its subsidiaries have probably the worst reputation in the payments space when it comes to fair pricing and transparency.
They pull out every trick in the book to pad their margins: hidden fees, frequent rate increases, bogus charges, all of it. And that’s on top of the absorbingly high rates to begin with. Basically all of the craziest rates and aggressive billing tactics we’ve seen over the years industry-wide have come from Global Payments.
So it’s definitely not ideal that this is the only processor that officially integrates with ChiroFusion through an API. I’d avoid this route.
Helcim
Helcim operates under a completely different rulebook.
They’re a payment facilitator (PayFac), which means they sit between you and the acquiring bank. And while their rates definitely aren’t cheap, they’re surprisingly competitive for this setup and interchange-plus pricing is available. That’s not common amongst all PayFacs, but it’s a positive for sure.
Helcim’s pricing gets better as your volume increases. For example, if you’re processing between $100k and $500k per month, their markup for online transactions starts at 0.35% + $0.20 per transaction. But that rate drops to 0.15% + $0.15 if you’re clearing $1M per month.
But they charge extra for things like Amex transactions and recurring payments from cards on file.
Another frustrating part about Helcim is that their in-person rates are barely better at most discount tiers. The percentage component is the same at all the higher levels, but the fixed per-transaction amount drops. But for the amount of an average transaction at a chiropractor, the percentage is far more important.
All of that said, Helcim’s pricing will probably still beat Global Payments because Global just isn’t competitive anymore.
But Helcim technically doesn’t integrate with ChiroFusion. It’s just a browser extension used as a workaround, and ChiroFusion could potentially even block access at any point.
So that’s something that could be looming over you with this path.
Your Next Move Depends on How You’re Set Up Right Now
Anyone reading this right now is likely in one of three possible scenarios below. And each one has a unique solution.
If You’re Currently Using ChiroFusion But Haven’t Integrated Payments Yet
Don’t force it.
Cost-wise, the best possible option for you right now is to keep your current processor and have payments run outside of ChiroFusion’s software. While this adds an extra step in your operations for reconciliation, I think the cost savings will likely be well worth it.
There’s almost no scenario where you save money by switching providers just for the sake of the integration. When you factor in the higher rates, new equipment, potentially cancellation fees, plus operational costs associated with the switch, you could easily be looking at an extra $10,000 annually to process the exact same card volume you do right now.
Instead, you could be negotiating better rates with your current processor trying to save $10,000 per year. So a $20k swing in your favor for staying vs. switching.
If You’re Already Using ChiroFusion With Integrated Payments
Then you’re probably overpaying. In this case, the best way to save is by figuring out where the overpayments are coming from and addressing them directly.
It looks a bit different for everyone.
For chiropractors on Global, it’s likely a combination of higher-than-normal discount rates combined with a bunch of other fees that could be pushing your effective rate above 4% or 5% when it should probably be well below 3%.
If you’re on Helcim using that browser extension for ChiroFusion, the first thing you should do is make sure you’re on a true interchange-plus setup instead of a flat rate plan. From there, ask for concessions on your discount rate instead of the fixed per-transaction fees, and the percentage component of your in-person transactions should definitely beat the online ones.
If You’re Evaluating ChiroFusion For the First Time
Don’t let your practice management software dictate your payment processing setup.
I’m definitely not trying to steer you away from ChiroFusion. But if integrated processing is a must-have for you, then you’re better off finding an EHR and practice management solution that supports a wide range of processors, including the one you already use.
Software costs are negligible compared to what you pay to accept card payments over time, and most of these tools are interchangeable. The same definitely can’t be said for payment processing.
Final Thoughts
These decisions can have major long-term cost implications for your practice. So don’t rush into anything.
90% of the time, your best move is to keep things simple. Which often means leaving everything the same and trying to get better rates with whoever is currently handling your payments.
Regardless of who that is, there’s likely more room than you realize to save money.
Contact my team here at MCC for a free audit, and we’ll show you how much you can save without changing anything. Whether you’re fully integrated, using a standalone setup, or somewhere in between, we can help. No matter who your processor is.