New From The Innovation Lab: Stop Absorbing Credit Card Fees. Start Saving. 

By Blakely Roth | July 31, 2026

Credit card processing fees are a quiet but significant drain on the bottom line — and high-volume healthcare organizations can no longer afford to absorb them. See how Clearwave is helping organizations offset processing costs with a fully compliant, automated surcharging solution built into the patient check-in experience. 

The State of Surcharging in Healthcare

Credit card processing fees compound quietly until they represent tens of thousands of dollars a year for mid-to-large healthcare organizations, leading many high-volume organizations to consider surcharging. 

Surcharging is legally permissible in most states, but compliance isn’t automatic — it requires accurate fee determinations, proper pre-transaction disclosure, exclusion logic for Medicare, Medicaid, debit, FSA, and HSA cards, itemized receipts and adherence to card network caps. Managing those determinations manually introduces error, risk and staff burden. 

However, today, one in four healthcare transactions now includes a surcharge, and 30% of healthcare leaders are actively exploring or have already implemented surcharging to protect their margins. The question is no longer whether surcharging is viable — it’s whether your practice has the infrastructure to do it in a way that’s both compliant and efficient.  

[Coming Soon] Automated Surcharging at Registration

Clearwave is introducing compliant surcharging through Clearwave Pay to help high-volume healthcare organizations automatically charge for accurate credit card processing fees at check-in. 

How It Works:

1. Automates Surcharge Determinations: Take the hassle out of surcharging for all. Clearwave will automatically calculate and present the correct surcharge—no manual work for billing teams.   
2. Ensures Patient Transparency from the Start: Clearwave will display point-of-sale disclosures, provide a detailed payment breakdown, offer alternative payment methods and send an itemized receipt after payments are made.   
3. Collects Without Changing Workflows: Add surcharging to existing check-in workflows to streamline the patient experience. Surcharges are applied accurately across Clearwave check-in modalities—kiosk, mobile, dashboard and tablet. 
4. Provides Modern Payment Options: Simplify the process even further for patients by providing modern payment options. Clearwave can collect the full patient responsibility via tap-to-pay, GooglePay and ApplePay.  
5. Monitors Performance with Ease: Track how surcharging impacts your bottom line. Monitor surcharged collections through the Clearwave Dashboard and pull reports to measure success. 

What Could Surcharging Save Your Practice?

For high-volume specialty practices, the math is direct. A compliant, 3% surcharge applied to credit card payments offsets most—if not all—of your processing fee exposure. Here are a few examples of how quickly the savings compound: 

• $26,000/month in credit card volume  → ~$780/month recovered | ~$9,360/year 
• $100,000/month in credit card volume  → ~$3,000/month recovered | ~$36,000/year 
• $200,000/month in credit card volume  → ~$6,000/month recovered | ~$72,000/year 
• $500,000/month in credit card volume  → ~$15,000/month recovered | ~$180,000/year 

*Estimated based on a typical 3% credit card surcharge. Actual results will vary. 

Stop Absorbing Fees. Start Saving at Every Check-in.

For practices with high credit card volume across multiple providers and locations, surcharging is one of the highest-ROI operational changes available — and with Clearwave, the implementation lift is minimal. 

Ready to see the impact surcharging could have on your practice? Schedule a demo today or download the Clearwave Surcharging data sheet to share with your team. 

Surcharging availability and set-up is based on a client’s merchant provider.  

Compliant surcharging is based on credit card fees, state regulations, and Medicare/Medicaid determinations, while excluding debit cards, FSA/HSA cards, prepaid cards and Medicare/Medicaid-covered services as required by law.