Which Payment Methods Should a Clinic Actually Offer?

The right answer is local

There is no universal correct set. The methods your patients expect depend on where they are, and offering a method nobody uses costs you reconciliation work for no revenue.

The practical rule: offer what most of your patients already use, plus cash, plus one fallback. Adding a fourth or fifth option rarely converts anyone and reliably creates work.

Instant versus manual is the real distinction

More useful than sorting by brand is sorting by how confirmation happens.

Instant (card, most wallets, domestic instant networks). The payment confirms itself. Nothing lands on your reception's desk. There is a processing fee, and that fee is what you are paying for the absence of admin.

Manual (bank transfer, transfer-and-receipt wallets). The patient transfers and provides proof; someone confirms it. No processing fee, but a real per-payment cost in attention — and payments that arrive without a reference are worse than the fee you avoided.

Most clinics want instant as the default and manual as the option that keeps working when instant is unavailable.

Cash has not gone anywhere

In many markets cash remains the majority of patient payments, and pretending otherwise produces reporting that does not match the drawer. The thing that matters is that cash is *recorded* at the point it is taken. A system where recording a cash payment is an extra optional step is a system whose earnings reports are fiction — see [what breaks as a practice grows](/blog/solo-doctor-to-multi-clinic-software-scaling).

Questions before adding a method

• What share of my patients would use this? If it is small, the reconciliation cost probably exceeds the benefit.
• Who confirms it, and when? If confirmation is manual, someone owns that daily.
• What is the fee, and am I absorbing it or passing it on? Decide deliberately; discovering it at month end is how margins quietly go.
• What happens on a refund? Some rails make refunds trivial, others make them a bank errand.

Two different sets of rails

Worth separating clearly, because they get conflated: the methods your patients use to pay you are local and belong to your market. The method you use to pay for your software is a separate question with a different answer — for us, an international bank transfer that works from anywhere, described in [how it works](/blog/international-bank-transfer-subscription-how-it-works).

How Roshtah handles the patient side

Available methods are per-country, because that is the only way they can be correct, and an operator switches on what is genuinely live in each market rather than advertising a rail that cannot take money. Whatever the method, what was actually paid is recorded against the visit so the earnings reporting reflects the drawer.