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Apply for Tebra Payments

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Updated: 03/28/2024 | Views: 6921

Tebra Payments gives practices the ability to collect patient balances faster and reduce time in accounts receivable. Unlike traditional payment options, Tebra Payments offers a robust messaging and payment solution that leverages text, email and mailed statements to ensure patients are communicated to in the right way, at the right time.

Tebra Payments provides the infrastructure necessary to accept and process electronic payments via a credit card. This allows practices to collect payments electronically from their patients when they have an outstanding balance due. In order to collect electronic payments using Tebra Payments, the practice must complete an application and be approved.

Benefits include:

  • Unlimited text and email balance reminders that includes a secure payment link
  • Secure credit card payments processed directly through Tebra
  • Automatic payment deposits into the practice's bank account
  • Enables patients to make online payments
  • QR code and pay online payment options on mailed statements
  • Automated Patient Billing feature

To complete the application, have the following information ready:

  • EIN/TIN (for businesses)
  • Financial Information: Average transaction amount, highest expected transaction amount, and average monthly sales amount
  • Bank Routing Number and Account Number (for the bank the moneys should be deposited into)
  • Primary Owner Social Security Number (SSN)
  • Additional Owner SSN (if applicable)

icon_warning.png Important Notes:

  • There are specific categories such as online pharmacies, prescription-only products including card-not-present pharmaceuticals, cannabis related practices/consultations, and products and services with varying legal status on a state-by-state basis that may be restricted. For further questions, contact Customer Care.
  • System Administrators can start and fill out the application, but the application must be signed by a practice representative.

For more information, review Tebra Payments FAQs. 

Generate Application

  1. Hover over the User icon and click on Practice Settings. The Practice Settings page opens.
  2. Click Tebra Payments. The Tebra Payments page opens.
    • If the application was saved as a draft, click Open Application to complete the application.
      • If the user receives an Insufficient User Role message, they do not have access to the application. Advise the practice representative to access the application from the link sent to their email.
 Platform_TebraPayments_Access.png
  1. Click Apply Now to navigate to the Apply section.
    • For billing company practices, select who is completing the form on behalf of the practice: Practice Staff or Billing Company Staff.
  2. Enter the Email and confirm it by entering the email again.
  3. Click Generate Application. An Application Ready confirmation message displays when the application successfully generates.
  4. Click Continue Application to start the application. The Tebra Payments Application page opens in a new browser window.
 Platform_TebraPaymentsApplication_Generate.png

Complete Application

The application has three sections: Business Information, Owner Information, and Agree & Sign.

If necessary, click Save at the bottom of the page to save the application as a draft to complete at a later time. The draft application can be accessed from the Tebra Payments page under Practice settings.

Business Information

  1. Internal Usage: The KID (account ID), Practice ID, Submerchant Type, are auto-populated from the account's information. The Primary POC (point of contact) displays the email entered when the application was generated.
    1. Click to select "Yes" or "No" to indicate if the practice is currently a Kareo Patient Collect customer using Stripe.
  2. Business Information: Enter all applicable details.
    1. Legal Business Name: Enter the business name.
    2. DBA: Click to select "Yes" or "No" to indicate if the legal business name is a DBA (Doing Business As) name.
      • If "No" is selected, enter the Business Name in the DBA (Doing Business As) field.
    3. Business Structure Type: Select from the available options: Sole Proprietorship, Partnership, Limited Liability Co., Non-Profit Corp., and Corporation.
    4. Business Tax ID: Enter the nine digit tax ID for the individual (e.g., sole proprietorship) or for the business.
    5. Business Established Date: Click the calendar icon to select a date.
    6. Business Telephone: Enter the business 10 digit phone number.
    7. Business Email: The email entered when the application was generated displays. If applicable, enter a different email address and ensure it is a valid and reliable email account that is checked often.
    8. Provider website: Click to select "Yes" or "No" to indicate if the business is using a Tebra Care Connect profile.
  3. Physical Business Location: Enter all applicable details.
    1. Business Address: Enter the business physical address.
    2. Multiple Locations: Click to select "Yes" or "No" to indicate if the business has multiple locations.
  4. Business Legal Address: Enter the address for billing and tax purposes.
    • If the business legal address is the same as the physical business location, click to select "Business location is the same as legal address". The address is populated with the same information as the physical business location.
    • If the business legal address is not the same as the physical business location, enter the business legal address.
  5. Business Questionnaire: Enter and select all applicable details.
  6. Financial Profile: Enter all applicable details.
    1. Average Transaction Amount: Enter the average amount the practice charges per transaction.
    2. Highest Expected Transaction: Enter the maximum amount the practice charges for one transaction.
    3. Average Monthly Sales Amount: Enter the average sales amount the practice makes per month.
    4. Banking Account Type: Select Checking or Savings.
    5. Bank Name: Enter the account's bank institution name.
    6. Routing Number: Enter the bank's routing number.
    7. Account Number: Enter the account number.
    8. Name on Bank Account: Enter the name on the bank account.
  7. Supporting Attachments: Upload supporting documents.
    1. Click Upload next to VOID Check or Bank Letter to attach a scanned VOID check or bank letter with the bank name, bank account owner, bank account number, and ACH routing number listed.
      • These forms cannot be accepted: Direct Deposit Forms, Bank Account Summaries, Counter/Starter Checks or Deposit Slips.
    2. If the business has been established less than a year, click Upload next to TIN Document to attach a government issued proof of business taxpayer identification (TIN Number).
  8. Click Next to continue.
 Platform_TebraPaymentsApplication_Business.png

Owner Information

If necessary, click Save at the bottom of the page to save the application as a draft to complete at a later time. The draft application can be accessed from the Tebra Payments page under Practice settings.

  1. Owner 1 Information: Enter all applicable details.
    1. First and Last Name: Enter the owner's full legal name, not a nickname.
    2. Date of Birth: Click the calendar icon to select a date.
    3. SSN: Enter the owner's SSN, not the business EIN/TIN.
      Note: The Primary Provider/Owner SSN is still required even if the EIN/TIN was entered under the Business Information section.
    4. Owner Email: Enter the owner's email address and ensure it is a valid and reliable email account that is checked often.
      Note: This email address will be used for legal documentation and can be the same email address as the Business Email.
    5. % Ownership: Enter the percentage of ownership that the owner has of the business.
    6. Owner Address: Enter the owner's residential address.
  2. Additional Owners: Click to select "Yes" or "No" to indicate if there is an additional owner who owns 25% or more of the business.
    • If "Yes" is selected, click Add. Then, enter the additional owner's Full Name, Date of Birth, SSN, Email, and residential Address.
  3. Practice Representative Signature: Indicate whether a practice representative or an owner is responsible for signing the form.
    1. If an owner is responsible for signing the form, click to select the Owner (e.g., Owner 1) from the drop-down. The owner's information populates from the information previously entered.
      • If the Owner selected is incorrect, click the X icon. Then, select the Owner (e.g., Owner 1) from the drop-down.
    2. If a practice representative is responsible for signing the form, enter their legal Last and First name, Email address, Date of Birth, and Phone Number.
      Note: The practice representative will receive a separate email from Tebra to complete the electronic signature process.
  4. Click Next to continue.
 Platform_TebraPaymentsApplication_Owner.png

Agree & Sign

If necessary, click Save at the bottom of the page to save the application as a draft to complete at a later time. The draft application can be accessed from the Tebra Payments page under Practice settings.

  1. Review the Terms and Conditions and Payment Processing Services Requirements.
  2. To accept the terms and requirements as an authorized representative, click to select the three attestation.
  3. Click Finish. The Merchant Application - Tebra page opens.
    • If the user accessing the Merchant Application - Tebra page is responsible for signing, proceed to sign the application.
    • If the user accessing the Merchant Application - Tebra page is not responsible for signing. The practice representation will receive an email from Tebra Payments with the application link to sign.
 Platform_TebraPaymentsApplication_Agree.png

Sign Application

icon_warning.png Important Note: The application must be signed by a practice representative.

After the application is submitted, the process typically takes 7-10 business days to complete. An email with the status of the application will be sent to the primary POC.

  1. Click Start to navigate to the last page to sign the application.
    • To review the application before signing, read the page and click the arrow icons to navigate forward or back.
  2. Click Sign to complete the application. The Signature Details pop-up window opens.
  3. Review the owner's full legal name, country, and electronic signature.
    • To draw a signature, click draw your signature. The Draw Your Signature pop-up window opens. Sign in the provided space and click Next when finished.
  4. Click Accept to sign the application. The confirmation pop-up window opens.
  5. Click Save and Send to complete the application. The confirmation pop-up window opens.
  6. The application is complete.
    • To save a copy of the application, click Download.
    • To close the application, click Exit.
 Platform_TebraPaymentsApplication_Sign.png
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