Here’s How a Louisiana OD Added a Card Fee Without Upsetting Patients

Dr. Crystal Gustin

FOR MANY PRACTICE OWNERS, rising costs are posing an increasingly urgent question: What can be absorbed, what must be passed on, and what simply can’t continue unchecked? At Today’s Eyecare, owner and optometrist Dr. Crystal Gustin kept running into one cost that made less and less sense the more she looked at it: credit-card processing fees. After years of watching those charges grow, she made a change that eased a long-standing frustration and brought surprisingly little resistance from patients.

THE IDEA

Gustin handles her own accounting alongside her bookkeeper, which means she sees every line of spending up close. One category in particular kept nagging at her. “Seeing the amount of money spent on credit card fees was disheartening; especially when compared to other costs to run the business,” she says. The impact wasn’t just on patient payments. Insurance reimbursements delivered via credit card or EFT were also chipping away at revenue: “So I have to now take a hit when the patient pays their measly copay with a credit card and now I have to take a hit from the insurance reimbursement.”

The scale of that monthly outlay was striking — comparable to a major facility cost — and out of proportion, in Gustin’s eyes, to what those fees actually delivered. And to her, the most obvious alternative just didn’t sit right. “From being a consumer myself I would like the option to not pay the fee as opposed to a business just unilaterally raising prices,” she says.

THE EXECUTION

Today’s Eyecare settled on a 2.5% credit-card processing fee, matching exactly what their processor charges. “We worked with our current credit card processor to set a system up that was easy for our staff to implement,” Gustin says. The company provided a compatible terminal and helped her team get it set up.

Communication with patients has been kept intentionally simple. “We have a sign, and when patients check out we tell them,” she says. Staff have been trained to explain the policy calmly and respectfully, and Gustin emphasizes being accommodating. “There’s times when patients want to leave to go get cash or a checkbook and we are very accommodating to that. They always come back and pay.”

THE REWARDS

While Gustin prefers not to share exact figures, she says the difference has been meaningful. “I really feel like it has. For a variety of reasons we are having our best year so far,” she says. The amount collected in fees remains close to what the practice used to pay out each month — a sign that most patients are continuing to use credit cards even when presented with alternatives. But the structure now aligns better with her sense of fairness and with the realities of running the practice.

“When we thought about implementing the fees we looked everywhere to find margin. It’s just not there because of the way fees and insurance kind of keep you from passing on rising costs,” she says. “I don’t like being forced into higher prices.”