# What telehealth companies need from a payment processor

Title: What telehealth companies need from a payment processor

Description: Underwriting, licenses, and why a faster signup is the wrong feature. Read November 9, 2026. Source pages linked. Compared with Stripe. No invented rates.

Telehealth is on Stripe's restricted list together with online pharmacies and card-not-present prescriptions. That single fact explains most of the payment pain. The processor is being asked to board a clinical business it may not be set up to supervise, in states it may not want the license exposure for.

## What should the processor do before you are live?

A useful processor does three unglamorous things. It reviews the licenses and the model before you are live. It tells you which products and which states the approval covers. It has a dispute process, because medical billing and subscription supplements attract chargebacks that are really "I didn't recognize it" and chargebacks that are really "the visit did not happen."

## Where does Frame Payments fit?

Frame is built around that review for US regulated businesses. The telehealth page says so, and it also says Frame has not published a list of models it will accept. A practice Stripe has already approved, with clean disputes, should not move for philosophy.

## What can no processor waive?

A few things processors cannot waive. A card network rule about pharmacies is not overridden by a payfac's API. A state that requires a particular clinician relationship will not accept a checkout form as a substitute. And a merchant of record for software companies is not a telehealth strategy. They are not going to be the seller of a prescription.

## What should you take to the review?

Bring the underwriter the same story your medical director would tell a board. If the marketing site tells a different story, you will fail the review no matter whose logo is on the application.

## Questions

### What should the processor do before you are live?

A useful processor does three unglamorous things. It reviews the licenses and the model before you are live. It tells you which products and which states the approval covers. It has a dispute process, because medical billing and subscription supplements attract chargebacks that are really "I didn't recognize it" and chargebacks that are really "the visit did not happen."

### Where does Frame Payments fit?

Frame is built around that review for US regulated businesses. The telehealth page says so, and it also says Frame has not published a list of models it will accept. A practice Stripe has already approved, with clean disputes, should not move for philosophy.

### What can no processor waive?

A few things processors cannot waive. A card network rule about pharmacies is not overridden by a payfac's API. A state that requires a particular clinician relationship will not accept a checkout form as a substitute. And a merchant of record for software companies is not a telehealth strategy. They are not going to be the seller of a prescription.

### What should you take to the review?

Bring the underwriter the same story your medical director would tell a board. If the marketing site tells a different story, you will fail the review no matter whose logo is on the application.

### Where were the figures on this page read?

The sources list names the pages. This edition was read on November 9, 2026. Stripe's US domestic card rate in that reading is 2.9% + $0.30, and a dispute received is $15.

## Sources

Last verified November 9, 2026.

- Stripe pricing: https://stripe.com/pricing?ref=https%3A%2F%2Fwww.stripealternatives.com

## Related

- [Visa's VAMP rules explained for merchants](/blog/visa-vamp-explained.md)
- [The real cost of a chargeback, by processor](/blog/cost-of-a-chargeback.md)
- [What we found verifying processors' pricing pages](/blog/verifying-processor-pricing.md)
- [Monthly pricing and policy changes](/blog/monthly-changes.md)
- [Payfac, gateway, acquirer, or merchant of record](/blog/payfac-gateway-acquirer-merchant-of-record.md)
- [Payments explainers](/blog.md)
- [Stripe alternatives directory](/index.md)
- [Stripe pricing and US card fees](/alternatives/stripe.md)