A healthcare SaaS platform provides practice management software to more than 2,800 medical practices across North America. It handles patient scheduling, electronic health records, billing, and telehealth for practices that range from small family clinics to large multi-specialty groups.
Payment processing was constraining the company’s expansion. Subscriptions run from $150 to $2,500 a month depending on practice size, and the company needed to support different payment preferences across regions without service interruptions. When a practice loses access to records or scheduling because of payment processor downtime, it affects patient care.
Healthcare’s compliance requirements added complexity: regional variations, different payment methods by practice type, and the reliability providers expect across markets. Engineering was spending a large share of its time on payment work rather than core software, and the backlog of customer feature requests kept growing.
Choosing Orchestra
The company evaluated payment orchestration platforms that could remove integration complexity and support international expansion, and selected Orchestra. Rather than build separate integrations for Canadian banking, Mexican payment methods, and US processors, it accessed all of them through one JavaScript library, which freed engineering to work on healthcare features.
What changed
Global payment support
Orchestra’s payment network gave the company regional methods without separate integrations: direct debit for Canadian practices, credit cards for US customers, and OXXO for the planned Mexico launch. When it expanded to Ontario, it accepted payments from Canadian practices on day one. Orchestra also handles PCI compliance and regional banking rules across jurisdictions, which removed months of compliance work from the expansion timeline.
Failover and uptime
Healthcare providers expect close to 99.99% uptime, and payment processing is part of that. Orchestra’s automatic failover routes transactions through backup processors when the primary gateway has problems, with no customer action. During a four-hour outage at the company’s primary processor last quarter, its customers kept processing payments through Orchestra’s backup routing.
How they integrated
The company uses Orchestra’s REST API for backend subscription processing and recurring billing, handling automated monthly billing for more than 2,800 practices across multiple currencies and payment methods, with billing cycles customized per practice. It uses the JavaScript library for embedded payment experiences in its practice management dashboard, so providers can update payment methods and view billing history without leaving their workflow.
Consolidating onto one integration cut payment-related development overhead by about 50%, replacing the separate codebases each processor previously required.
Results
The company now serves practices in 47 US states and 6 Canadian provinces and processes payments in 3 currencies. Monthly recurring revenue has grown from about $5.6 million to $7.8 million, and engineering now spends most of its time on core product rather than payment maintenance.
The integration also let the company add a flexible payment schedule that aligns practices’ subscription payments with their own patient billing cycles.
