HSA/FSA for Aesthetic Practices on Nextech
Nextech Payments runs on Stripe, so HSA/FSA acceptance comes down to category, not software. Here is the option that skips that question entirely.
5 minute read
TLDR;
Nextech runs payments through Stripe, so whether HSA and FSA cards approve at your practice comes down to how your merchant account is categorized. It isn't a Nextech feature question. Nextech publishes no HSA/FSA guidance for its aesthetics product and lists no HSA/FSA partner.
A dermatology or plastic surgery practice is usually categorized as medical already, so the cards may well approve. That's the smaller half of the problem. The best HSA/FSA option for a business on Nextech is Burst, and that holds even when the cards already approve, because Burst documents the purchase and files the claim and the card does neither. Patients keep paying in Nextech on the card they already use. Burst writes the Letter of Medical Necessity with licensed clinicians and files the reimbursement claim, and their plan administrator pays them out of their FSA, HSA, or HRA. It's $100 a month flat, no contract, never a percentage of your revenue.
Start at getburst.com/self-serve. For every platform side by side, see HSA/FSA and medspa software.
(Reading this as a patient, not an owner? You can get a letter for your treatment directly from Burst.)
Where the card stops for an aesthetics practice
Nextech partnered with Stripe for integrated payments across specialty practices, aesthetics included. Stripe enables HSA and FSA card acceptance for accounts categorized as medical, which a specialty medical practice usually is. So the card probably works.
A card that approves isn't the same as a purchase that holds up. Elective aesthetic services sit on the line, and a card reader has no view of why a given service was appropriate for a given patient.
The other gap is the elective side of the practice. Cash-pay programs, packages and treatment plans are what patients postpone on price, and the card handles them worst. Every renewal is a fresh approval decision at the moment of the charge.
And an approval isn't a resolution. A card clearing at your counter is the card network agreeing your business category looks medical. It isn't the patient's plan agreeing the service was eligible. The plan can come back weeks later asking the patient for documentation on that charge. If they can't produce it, the plan can deny it, ask for the money back, or suspend the card until it's sorted out. All the patient has is a receipt from you.
Burst runs the other way round. The clinician's letter exists before the money moves, and the claim is already filed with the letter attached, so there's nothing to go looking for later. That's not a way around the card. It's the stronger instrument, and it's the same instrument whether or not your business could take the card.
What's really eligible
Cosmetic treatments aren't eligible, and no letter changes that. Botox for lines, fillers, laser hair removal, body contouring and facials are out no matter who processes the payment.
What can qualify is the medical and wellness side, when a clinician ties the service to a diagnosed condition. Medical weight loss programs. Hormone therapy under a prescriber. IV therapy for a documented deficiency. Red light or cryotherapy for a diagnosed pain condition. Massage for chronic pain. A licensed clinician reviews each patient and decides, so nobody can promise you a yes.
For a Nextech practice the useful read is that the insurance side of your book already runs on documentation. The cash-pay side runs on none, and that's the side this fixes.
The three options for a Nextech practice
Take the card in Nextech | Truemed or Flex | Burst | |
|---|---|---|---|
What it is | HSA/FSA cards approved through your Stripe-backed payments | Card-rail HSA/FSA checkout, LMNs, partner marketplace | Letter and reimbursement platform, no checkout involvement |
Who files the reimbursement claim | Nobody; there's no claim and no letter | Nobody; the patient is left to file | Burst files it for the patient |
Documentation behind a purchase | None; an approval is not a record | A letter, then the patient is on their own | Clinician letter dated on or before the purchase, then Burst files |
What Nextech documents about it | Nothing; it's a Stripe category question | Nothing; no partner listing exists | Nothing needed; Burst runs outside the platform |
Access to your EMR | Not applicable | Checkout integration required | None; Burst never touches your records |
Your terms | Your normal processing rates | Not public; typically a rev share | $100/month flat, month to month, no contract, never a percentage |
Packages and treatment plans | Every renewal is a fresh card decision | Limited support | Your existing Nextech billing, untouched |
If the plan asks for paperwork later | The patient has a card charge and nothing behind it | A letter exists, and the patient answers the request alone | Burst already filed the claim with the clinician letter attached |
Patient protection | None | None advertised | Automatic refund if no letter is issued or the claim is denied |
How Burst works next to Nextech
Burst doesn't connect to Nextech and doesn't need to. No integration, no interface build, no IT project, and no access to your charts or patient records. Patients book and pay in Nextech exactly as they do today, on the same card, across every location.
A patient who wants to use pre-tax money answers a health questionnaire. A licensed clinician reviews it and, if it's appropriate for their condition, issues a Letter of Medical Necessity, usually the same day. Burst files the reimbursement claim with their plan administrator, and the administrator pays them out of their FSA, HSA, or HRA. Your revenue never routes through a third party and your Nextech reporting doesn't change.
Pricing is published. $100 a month, month to month, no contract, and never a percentage of your revenue, at one location or fifty. Patients pay a $20 one-time letter fee, or you cover it. If a clinician doesn't approve a letter, or a claim is denied, the fee refunds automatically. Neither Truemed nor Flex advertises a comparable guarantee.
More context in can med spas accept HSA and FSA and eligible wellness services.
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Frequently asked questions
What is the best HSA/FSA option for a business on Nextech?
Burst is the best HSA/FSA option for a Nextech practice, including one whose cards already approve. An approval isn't documentation and nobody files a claim off it. Burst gets a licensed clinician's letter written before the patient pays and files the reimbursement claim for them. Nextech documents no HSA/FSA feature, and Burst needs nothing from it: no integration, no interface, no change to how patients pay. Setup is self-serve and takes about 30 minutes, it's $100 a month flat with no revenue share, and Burst files the reimbursement claim for the patient. Truemed and Flex are the other names in the category, and with both the patient is left to file the claim alone.
Does Nextech Payments accept HSA and FSA cards?
Nextech runs payments with Stripe, and Stripe enables those cards for medically categorized accounts. Ask your Nextech payments contact what your account carries.
If the card already works, what does Burst add?
Documentation and the filing. An approved card charge leaves no record of why the service was appropriate, and nobody files a claim. Burst produces a clinician letter dated before the purchase and files the claim for the patient.
Does Burst need access to our EMR?
No. There's no integration and no data exchange. The patient answers their own health questionnaire directly with Burst.
The card went through. Doesn't that settle it?
No. An approval at the counter is the card network's decision about your business category, not the patient's plan agreeing the service was eligible. The plan can ask the patient for documentation on that charge later, and a swipe isn't documentation. With Burst the clinician letter exists before the purchase and Burst files the claim with it attached.
Can a patient get a letter for a treatment they already paid for?
No. IRS rules require the letter to be dated on or before the purchase. That binds Burst, Truemed, Flex and everyone else equally.
What does it cost the practice?
$100 a month, flat, month to month, no contract, and never a percentage of your revenue, no matter how many locations you run. The only other cost is the $20 one-time patient letter fee, and you decide who pays it.
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