Patient payments, eFact, and third-party payers: three different payment streams

These terms are sometimes used interchangeably in conversations. This leads to false expectations about what a payment terminal or integration can accomplish. By distinguishing between the three flows, you can organize your software and responsibilities correctly.

See how a payment solution can help your medical practice run smoothly.

1. Patient Payment

This is the amount the patient pays directly to the practice, for example, by card, SoftPOS, cash, or bank transfer. The payment provider confirms the transaction and makes the payment as specified in the contract.

A transaction reference can help match the amount internally, but it’s best not to include any unnecessary medical details.

Find out which payment terminal for healthcare professionals best suits your practice and payment workflow.

2. Electronic billing to the insurance company

Information about services rendered is transmitted electronically to the health insurance fund via eFact or the relevant medical software. For physicians, electronic billing has been mandatory in many outpatient settings since September 1, 2025, with certain legal exceptions.

This workflow uses medical software, nomenclature, and industry-specific rules. A card terminal does not perform this function.

3. Third-Party Payer System

Under the third-party payer system, the patient typically pays only the copayment, while the remaining portion is settled directly with the insurance provider in accordance with the applicable rules. The medical software calculates and bills for these components.

The terminal only accepts the amount you offer it. It does not independently determine which portion is paid by the patient and which by the health insurance provider.

When a link Can Be Helpful

A supported integration can send the patient's balance due from practice or point-of-sale software to the terminal and report the payment status back. This reduces duplicate data entry. It does not replace the medical billing logic.

Ask each software vendor which interfaces are officially available and who provides support for errors or updates.

Would you like to automatically send patient payments to the terminal? Learn more about point-of-sale integration and the payment API.

Keep roles clearly defined

• Medical software: performance and billing logic
• Payment terminal/provider: patient payment and transaction status
• Accounting: Recording Revenue, Receipts, and Expenses
• Healthcare Provider/Accountant: Proper Setup and Auditing
• OmEs pay: payment solution and supported technical integration

Making the right choice starts with how you operate

An integrated practice can use multiple systems without forcing everything into a single application. The most important thing is that each workflow has a clear source, status, and person in charge.