> ## Documentation Index > Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt > Use this file to discover all available pages before exploring further. # Choose your POS system > Picking the payment system for patient payments, Square, Stripe, Worldpay, and healthcare-specific processors, plus the healthcare-specific setup: MCC codes, HSA/FSA cards, card-on-file, memberships, and surcharging. Whether you're cash-pay only or in-network everywhere, patients hand you a card every day, copays, deductibles, cosmetic work, memberships. The POS decision is less about the reader on the counter and more about four things: what it costs at your volume, whether it talks to your EHR/PM ledger, whether HSA/FSA cards work, and how well it handles card-on-file and recurring plans. ## The contenders | System | Best fit | Typical pricing | The catch | | ------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------- | --------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------- | | **Square** | Solo and small practices that want in-person + invoices working in a day | \~2.6% + 10¢ in person; \~2.9% + 30¢ online | Fast onboarding, but healthcare is a monitored category, set your business category honestly or risk a frozen account | | **Stripe** | Online-first: telehealth checkout, booking-flow payments, anything custom | \~2.9% + 30¢ online; Terminal readers for in-person | No patient-facing billing UI of its own, you'll use it through your EHR, booking platform, or membership software | | **Worldpay / Global Payments / Elavon** (traditional merchant accounts) | Higher-volume practices (roughly \$30-50k+/mo on cards) that want negotiated interchange-plus pricing | Negotiated | The contract: early-termination fees, auto-renewal, and equipment leases are where these deals go bad, read before signing | | **Healthcare-specific platforms** (Rectangle Health, Clearent, EHR-native processing) | Practices that want card-on-file, payment plans, and ledger posting out of the box | Varies; usually a premium over raw processing | Verify the EHR integration actually posts to the ledger, not just a payment link in an email | **A reasonable default:** start on Square (in-person-heavy) or Stripe (online-heavy) under transparent flat pricing; renegotiate into interchange-plus with a traditional processor when monthly card volume makes the savings real; switch to EHR-native processing when posting payments by hand starts costing staff hours. ## Set it up like a healthcare business However you choose, the setup mistakes are the same ones: **Open the account under the entity, not yourself.** Legal name and EIN of the practice (or the PC, in an [MSO/PC structure](/guides/own-a-practice-without-a-license), patient revenue belongs to the PC). Processing under your SSN ties 1099-Ks and processing history to you personally and complicates a future sale. **Set the business category (MCC) honestly.** The MCC does two jobs: it keeps the processor's risk team from freezing a "miscategorized" medical account, and it's what lets patients' **HSA/FSA debit cards** approve, those cards only work at healthcare-coded merchants. If a patient's HSA card declines anyway, they can pay normally and submit the receipt to their plan for reimbursement. **Settle to a dedicated account.** Point deposits at the practice operating account so card revenue is identifiable on the bank statement, it makes [reconciliation](/concepts/reconciliation) and month-end close dramatically easier ([account structure](/concepts/practice-banking-structure)). **Keep receipts and descriptors HIPAA-clean.** Statement descriptor = the practice's public name (unrecognized charges become disputes); no diagnosis or treatment details on receipts or invoice line items. **Get card-on-file authorizations in writing.** Stored cards with signed authorization are the backbone of payment plans and no-show fees, and the first thing a chargeback review asks for. ## Memberships, packages, and recurring plans If you run a membership or prepaid package model, the POS needs real recurring billing (not staff re-keying cards monthly). Two compliance tripwires to design around, with your attorney: several states regulate prepaid healthcare plans as insurance if they promise future services for a fixed fee (structure as discount-plus-per-visit where that's a concern), and auto-renewal laws, California's especially, require clear disclosure, affirmative consent, and easy cancellation. More on the model itself: [hybrid & membership practices](/concepts/practice-models-hybrid). ## Surcharging and cash discounts Passing card fees to patients is legal in most states but tightly regulated: credit surcharges are capped (roughly your actual cost, max \~3-4%), must be disclosed before payment, and can never apply to debit cards, HSA/FSA cards are debit cards. Many practices skip the whole mess with a cash discount instead. Check your state's current rule before enabling either. ## Related * [Patient responsibility](/guides/patient-responsibility) * [Patient financing](/guides/patient-financing) * [Send patient refunds](/guides/send-patient-refunds) * [How to structure your bank accounts](/concepts/practice-banking-structure)