Telehealth, telemedicine, wellness subscriptions
A telehealth and wellness payment gateway for clinics and platforms.
OpenGate is a payment gateway for telehealth clinics and wellness platforms that need a merchant account for consultation and membership billing. Clinics bill by consultation, platforms bill subscriptions, and both stand or fall on chargeback ratios and clear billing. We read the pricing model, the prescribing flow and the dispute history, then prepare the file for an acquirer that underwrites healthcare-adjacent billing.
At a glance
Telehealth & Wellness
- Sector
- Wellness & pharma
- Payment methods
- Cards (Visa/Mastercard) · MOTO and virtual terminal · Recurring billing
- Documents in the file
- 5
- First answer
- Within 1 business day
Why processors refuse
Why mainstream PSPs refuse telehealth and wellness
Healthcare-adjacent billing scares generalist processors. Consultations are high ticket and card-not-present, subscriptions renew monthly, and the regulatory picture varies by jurisdiction, so acquirers decline the category rather than read the pricing model. Providers with clean histories and licensed clinicians get the same refusal as everyone else.
Card-not-present consultation billing
A video consultation is sold and delivered without a card present, at a high ticket. Card schemes treat that pattern as higher dispute risk, and processors tuned to retail refuse it.
How OpenGate handles it
We tune fraud scoring and 3DS2 routing to consultation patterns, with velocity checks that match how clinics bill. The acquirer sees a documented card-not-present model, priced for what it is.
Subscription and membership churn
Wellness platforms bill monthly memberships, and members dispute renewals they forgot or no longer want. Scheme monitoring programs punish subscription dispute patterns, which is why processors flee the vertical.
How OpenGate handles it
The billing model is mapped in the file, and recurring mandates are configured before go-live. Dispute tracking watches subscription reason codes, and the reserve is sized to the plan structure in writing.
Regulatory and privacy complexity
Telehealth sits under health regulations and privacy rules that vary by market, HIPAA in the United States among them, and acquirers must confirm the provider holds the required licenses before boarding. A processor that cannot verify that refuses the file.
How OpenGate handles it
We list the licenses and privacy documentation each acquirer expects for your jurisdictions. The provider's authorizations stay the provider's; the gateway handles the payment flow, the routing and the dispute management.
Chargebacks from billing confusion
Patients dispute charges they did not recognize, especially when the descriptor does not match the clinic name. No-show fees and surprise balances drive the same pattern.
How OpenGate handles it
The checkout and the descriptor are reviewed during underwriting, because the patient must recognize the charge later. Alert feeds catch disputes before they become chargebacks, and representment files the evidence.
Prescription and fulfillment scrutiny
Platforms that connect prescriptions to dispensing add a compliance layer acquirers read line by line. The card schemes expect acquirers to vet merchants that sell prescription products online, and many acquirers ask for a third-party certification such as LegitScript. Files that describe the prescribing flow clearly move; files that hide it die.
How OpenGate handles it
The file describes the prescribing and fulfillment flow, with the licensed clinicians named by role. The acquirer evaluates the flow before activation, and the offer records what was approved. Certifications stay yours to obtain; we tell you which acquirers ask for them.
The file
How we underwrite a telehealth merchant account
The file starts with the pricing model and the prescribing flow. We read what the patient is charged, when, through which channel the prescription moves, and how disputes have behaved, then prepare the file for an acquirer whose healthcare program fits. Clinics and platforms file differently, and the offer reflects that.
Professional licenses
Copies of the clinical licenses and registrations for the providers involved. Required at onboarding, with the scope matching the jurisdictions served.
Pricing and billing model
The consultation fees, membership plans, no-show policy and refund policy, as the patient sees them. Evaluated before activation against the live checkout.
Prescribing and fulfillment flow
A written description of how consultations lead to prescriptions and how prescriptions reach the patient, with any pharmacy certification you hold. Acquirers read this against the platform's terms.
Processing history
Volume, chargeback and refund reports from the last three to six months, split by service line where available.
Corporate and ownership records
Registration, shareholder structure and UBO identity documents. Standard KYC for every merchant file.
Payment methods
Payment methods for telehealth and wellness
Patients pay by card on file, by link and by phone; the checkout handles all three.
Cards (Visa/Mastercard)
Consultation and plan payments through 3DS2 routing, with card-on-file for returning patients.
MOTO and virtual terminal
Mail-order and telephone-order payments through the virtual terminal, for clinics that bill over the phone.
Recurring billing
Membership and care plan subscriptions with scheme-compliant mandates and renewal tracking.
Pay-by-link
Invoice links sent to patients for consultations and balances, with expiry and limits.
The process
A telehealth file follows the same four steps as every vertical: file, analysis, offer, go-live. It starts with the application at /apply, where you state the markets you serve and whether prescriptions are involved. The full sequence is documented on /how-it-works.
FAQ
Telehealth and wellness payment processing FAQ
Can I use Stripe or PayPal for telehealth?
Why do patients dispute consultation charges?
Do I need special licenses to accept telehealth payments?
What documents do I need for a telehealth merchant account?
How long does onboarding take?
What reserve should a telehealth platform expect?
Can patients pay by phone or invoice?
Why was my telehealth merchant account closed?
Do you process memberships and care plan subscriptions?
Related guides
What Is a High-Risk Merchant Account? The Complete Guide
A plain-language walkthrough of high-risk merchant accounts: the classification, the account structure, the application, and the habits that keep it open.
Getting approvedExplainer10 min readHow High-Risk Merchant Underwriting Works
What an underwriter reads in your file, how the four steps of high-risk underwriting run, why files get declined and how to prepare a file that gets placed.
Getting approvedExplainer10 min read3DS2 and SCA for High-Risk Merchants
What 3DS2 and Strong Customer Authentication actually do, how the liability shift works, which exemptions apply, and how high-risk merchants should route authentication.
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Telehealth & Wellness
Open your telehealth gate.
Send the licenses, the pricing model and your processing history. An underwriter reads the file within 1 business day and replies with a written offer, a document list, or an honest no.
Free to apply. A human answer within 1 business day.