What is the difference between a transaction fee and a revenue share?

A transaction fee tracks the real cost of processing a card payment and typically falls as you scale. A revenue share claims a percentage of your margin and rises with your success. Benchmark any transaction fee against Stripe's published 2.9% plus 30 cents.

Why does merchant of record matter so much?

It determines whose account the patient's money lands in, who holds the stored card tokens, and therefore what leaving costs. If the platform holds your tokens, migration means asking every subscriber to re-enter payment details, and a meaningful share never do.

Glossary

The words that decide what a platform actually costs you.

31 terms, defined plainly. Most of them look like jargon and are actually commercial terms in disguise: merchant of record decides what leaving costs, card tokenization decides whether you can leave at all, and a transaction fee and a revenue share are not the same thing however similarly they are described.

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Economics2

Revenue share

A pricing model in which a telehealth platform takes a percentage of the brand's patient billings, so the platform's income grows every time the brand's marketing works.

Flat fee pricing

A pricing model in which a telehealth platform charges a fixed monthly amount regardless of how much revenue the brand generates.

Payments8

Transaction fee

A percentage charged on each patient payment to cover payment orchestration and billing infrastructure, distinct from a revenue share because it tracks processing cost rather than claiming a share of margin.

Merchant of record

The legal entity whose merchant account receives a patient's payment, and which therefore holds the card tokens, the chargeback liability and the payout timing.

Card tokenization

Replacing a patient's card number with a secure token that can be charged again later, which is what makes a subscription possible without storing the card itself.

Rebill engine

Billing infrastructure that charges a stored card on the day a prescription actually ships, at the dose that shipped, rather than on a fixed calendar date.

Involuntary churn

Subscription revenue lost to failed payments rather than to a patient choosing to cancel, usually caused by expired, reissued or declined cards.

Multi-MID routing

Distributing card volume across several merchant IDs so that no single processor relationship becomes a single point of failure for the business.

High-risk merchant account

A payment processing account for a business category that processors classify as elevated risk, which in telehealth commonly means higher rates, rolling reserves and closer scrutiny.

Chargeback

A forced reversal of a card payment initiated by the patient's bank, which returns the funds and typically adds a fee regardless of whether the merchant wins the dispute.

Compliance6

LegitScript certification

A third-party certification that verifies a telehealth or pharmacy operation is legitimate, and which Google, Meta and TikTok all require before serving ads for prescription products.

Management Services Organization (MSO)

A corporate structure that separates the business entity from the professional entity practising medicine, used to comply with corporate practice of medicine rules.

Corporate practice of medicine (CPOM)

The legal doctrine, applied differently by each state, that restricts non-physicians and corporations from owning medical practices or influencing clinical decisions.

HIPAA Business Associate Agreement (BAA)

A contract required by HIPAA between a covered entity and any vendor that handles protected health information on its behalf, setting out permitted uses and breach obligations.

Protected health information (PHI)

Individually identifiable health information held or transmitted by a covered entity or its business associate, which HIPAA regulates.

State licensure

The rule that a clinician must be licensed wherever the patient happens to be sitting during the encounter, rather than wherever the clinician or the company is based.

Clinical9

Asynchronous telehealth

Care delivered without a live appointment, where the patient submits an intake and a licensed provider reviews and prescribes on their own schedule.

Async vs sync visits

The distinction between asynchronous review of a submitted intake and a live synchronous video visit, which determines a telehealth program's cost, conversion and state coverage.

Compounding pharmacy

A licensed pharmacy that prepares customised medications for individual patients, including formulations and dose forms not available commercially.

503A vs 503B

Two categories of compounding facility: 503A pharmacies compound for individually identified patients, while 503B outsourcing facilities register with the FDA and may compound in batches.

GLP-1

A class of medications that mimic the glucagon-like peptide-1 hormone to regulate appetite and blood sugar, including semaglutide and tirzepatide.

Titration

Adjusting a medication dose in steps over time, guided by patient response and tolerance, rather than prescribing a fixed dose from the start.

Testosterone replacement therapy (TRT)

Treatment of clinically low testosterone with prescribed testosterone, which in the United States is a DEA Schedule III controlled substance.

Hormone replacement therapy (HRT)

Treatment of menopause and perimenopause symptoms with estrogen, usually with progesterone where the patient has an intact uterus, or with non-hormonal alternatives.

Peptide therapy

Treatment using short chains of amino acids, prescribed by a licensed provider and prepared by a licensed compounding pharmacy, for goals such as recovery, sleep and energy.

Operations6

Pharmacy routing

Automatically selecting which pharmacy fills each order based on the specific medication, the patient's state, cost and fulfillment speed, rather than sending everything to one partner.

Cold chain

Temperature-controlled storage and shipping that keeps a medication within its required range from the pharmacy to the patient's door.

White-label telehealth

Infrastructure that lets a brand operate a telehealth clinic under its own name and domain, with the underlying platform invisible to the patient.

Data portability

The ability to export patient records, order history and card tokens from a platform in a usable form, on demand, without a negotiation.

Patient portal

The branded interface where a patient tracks shipments, completes check-ins, messages their provider and manages payment methods after checkout.

Intake form

The structured clinical questionnaire a patient completes before treatment, which captures history and runs the eligibility screening that decides whether they can be prescribed for.

FAQ

Start here

Merchant of record, revenue share, card tokenization and data portability. Those four decide who receives your patients' money, how much of it reaches you, and what it costs to leave. Everything else on a feature list is secondary to them.

Now compare the terms you were actually offered

Bring a competitor's quote. We will tell you what it means in the vocabulary above, including where it beats ours.

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