OrthoFi is an industry leader in the orthodontics practice management space. They provide a range of solutions to help orthodontists streamline insurance billing, manage receivables, and process payments—all from a single source of truth.
Here at MCC, we have tons of clients in the dental and orthodontics industry, which means we have lots of experience with OrthoFi for integrated payment processing.
So whether you’re thinking of using OrthoFi, OrthoBanc, or Breeze, or you’re currently using these solutions and want to better understand your fees, this review has you covered.
Our Quick Take on OrthoFi
Overall, our clients using OrthoFi are generally happy with the software. It serves its purpose well, and supports integrated payments from multiple angles.
As we narrow the focus to integrated payments processing, it’s safe to say that OrthoFi is solid but still not perfect.
Pros
- Interchange-plus pricing is available.
- Friendly and responsive customer service.
- They’re willing to negotiate your rates (if you approach this properly).
- Ability to seamlessly accept payments through a truly integrated solution.
Cons
- The advertised flat-rate pricing is higher than you should pay.
- Some payment models are overly complex in a way that makes it harder to understand your fees.
- Not as comprehensive as other practice management solutions in terms of patient-specific features.
- Rate increases are more common and frequent than we’d prefer to see.
OrthoFi Overview
OrthoFi really took off after its merger with OrthoBanc about five years ago. This gave OrthoFi tons of additional capabilities for patient financial management under the same roof as its core product.
For credit card processing, OrthoFi relies on Breeze as its integrated payments solution.
Breeze is simply the payment processing division of OrthoFi/OrthoBanc—but it’s all the same company.
This is important to understand because our clients often get statements and communication coming from different departments of what’s really just one big organization. It usually depends on how you were initially onboarded and what products you’re using.
It’s also worth noting that while OrthoFi has its own in-house payment processing solution (Breeze), you’re not forced to use Breeze for integrated payments. Additionally, Breeze integrated with other practice management systems, so you have options.
OrthoFi Payment Processing Integrations
There are essentially two ways to set up integrated payment processing via OrthoFi—you can use Stripe or use Breeze.
Stripe
Stripe is one of the best payment technology providers on the market today. They’re typically a better option for large-scale ecommerce shops and online businesses that need to set up complicated payment systems (not necessarily known for working with dentists, orthodontists, and oral surgeons).
That said, Stripe does support in-person payments, and orthodontists can use it to give their patients flexible payment options.
You can integrate OrthoFi with Stripe to set up a traditional in-office POS, bill your clients via text or email, set up online payment links, set up recurring payments, or some custom combination of this.
Stripe’s processing rates are typically better than what you’ll get from Breeze. On a standard interchange-plus deal, we’ve seen Stripe contracts around 20-25 basis points. High-volume businesses (processing over $1 million per month) can do a bit better—as low as 10-15 basis points per translation.
Read our full Stripe review to learn more.
Breeze
Breeze is OrthoFi’s in-house payment processing division. So while you may pay a bit more, many of our clients like the convenience of getting everything from a single provider.
Here’s an example of a client we have using OrthoFi with Breeze:
They’re paying a 2.59% effective rate, which isn’t bad for an integrated processing solution.
Breeze typically tries to pitch a 2.89% + $0.15 per transaction flat-rate deal to new customers. So this effective rate here is less than that, and there’d be a bit more room to get that rate down if the merchant had a higher processing volume.
This merchant is paying 2.54% + $0.15 per transaction, which you can see here:
The effective rate would likely be less if the merchant was on an interchange-plus deal.
However, we don’t typically see Breeze offer interchange-plus markups below 40 basis points (whereas Stripe can be about half that).
Check out our in-depth Breeze review for more insights.
Rate Increases and Other Fees to Look Out For
OrthoFi increased its processing rates on July 1, 2025 for practices using Breeze. Flat-rate clients paying 2.54% + $0.15 per transaction were notified that their new rates would be 2.69% + $0.15 per transaction.
ACH payments increased $0.85 to $0.95 per transaction.
There’s also a new $95 monthly fee per location, and a $26 activation fee for new patients.
Practices using OrthoFi with Stripe are unaffected by this particular rate increase, as it’s technically coming from Breeze.
Read More: How Flat Rate Credit Card Processing Eats Into Your Profits
OrthoFi Alternatives
Dolphin Practice Management is a popular OrthoFi alternative that many of our dental and orthodontics clients use.
While the two tools have some overlapping practice management capabilities, they tend to serve different functions.
OrthoFi specializes more in the financial aspects of orthodontics practice management, while Dolphin is a bit more comprehensive for things like new patient paperwork, scheduling, appointment histories, and more. Dolphin even offers solutions for things like imaging and diagnostics, which isn’t something you’ll get from OrthoFi.
Some practices even utilize both systems, relying on OrthoFi for payments and collections while utilizing Dolphin for everything else.
If you use Dolphin instead of OrthoFi, you can set it up with Breeze as your integrated processor. Dolphin also integrates with Global Payments (which isn’t an option for OrthoFi users).
How to Lower Your Payment Processing Rates With OrthoFi
If you’re using an integrated processor like Breeze or Stripe to accept payments in OrthoFi, you’re always going to pay a slight premium. That’s just how it works with integrated processing.
But that doesn’t mean you should be getting ripped off. Here are some tips to help you save:
- Try to get on an interchange-plus pricing model instead of a flat-rate plan.
- Know your processor’s “rock-bottom” number (around 40 basis points for Breeze and 10-25 basis points for Stripe, depending on volume).
- Keep an eye out for additional miscellaneous fees on your statement and try to get them removed.
- Don’t just accept rate increase notifications—push back against them (you have more leverage than you realize).
Doing all of this on your own can be intimidating for inexperienced users. Statements can be tough to understand, and you may not be sure which fees are legit and which ones can be negotiated.
Here at MCC, we can audit your statements to identify savings opportunities and negotiate directly with OrthoFi on your behalf.
We can help you lower your rates, regardless of how your integrated processing solution is set up—and you won’t have to switch providers or change any of your current systems.
Final Thoughts on OrthoFi Integrated Processing
OrthoFi is great at financial management for orthodontics practice management. But as an integrated processor, it’s pretty average.
I do love their customer support. They’re friendly, personalized, and responsive.
Even the rate increase notifications tend to come directly from an account manager with detailed information for your practice, instead of mass emails with hidden charges buried in a notice.
But an increase is still an increase, even if it comes with a big smile and a cherry on top. Plus, OrthoFi’s in-house processing with Breeze can be expensive, and you don’t have tons of other options at your disposal aside from Stripe.
It’s also too bad that interchange-plus pricing isn’t available on every account. A single-location orthodontics practice processing less than $100k per month will probably get stuck on a flat-rate contract using OrthoFi with Breeze.
If you’re using OrthoFi, I probably wouldn’t consider moving away from them or anything like that. But you can definitely take steps to lower your costs. A simple audit can save you tens of thousands per year.