Payments · Telehealth6 min readUpdated November 3, 2026

Merchant Accounts for New Telehealth Companies

How a new telehealth company gets a merchant account with no history: what replaces it, what providers ask, offers to hold back, terms to expect.

Nick Bonnassies, CMO at Tagada · checked against 13 sources

Article summary

TL;DR

Yes, a new telehealth company can get a merchant account without processing history. Underwriters judge your clinical setup instead: licensed clinicians in the states you serve, a documented prescribing process, clear plan terms and who sells the medication. Stripe reviews telemedicine case by case; high-risk providers ask for more documents. Expect a reserve or volume cap at first.

Stripe restricts "Telemedicine and telehealth services" and says applicants "typically need to provide items such as license numbers and information on your processes" (read November 2, 2026).
Stripe doesn't require LegitScript for telemedicine; Corepay says LegitScript or VIPPS proof "is required to approve a merchant account".
PaymentCloud asks for three months of bank statements and three months of processing statements.
Published starting terms for new high-risk files: a 5% to 10% reserve held 90 to 180 days.
As of November 2, 2026, the DEA's telemedicine flexibilities for controlled substances end December 31, 2026.

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On this page

This guide is part of our hub on telehealth payment processing. The general guide, for any business: merchant accounts for startups with no processing history.

What replaces processing history for a telehealth brand

Without statements, the underwriter reads your setup. For telehealth, the clinical side weighs as much as the founders and the bank.

Without history, they look at	What to prepare
Owners	ID for each owner of 25% or more and one controller5
Clinicians	Names, license numbers and the states each one covers2
Prescribing process	How a patient is assessed, when a visit is synchronous, what happens on a decline2
Who sells what	Consult or membership only, or medication too, and which pharmacy
Plan terms	Price, billing cycle, how to cancel, shown before payment9
Bank statements	Three months, the owner's if the company is new3 6
Site	Live pages with terms, refund policy, contact and company details matching your documents

Fig. 1A first telehealth application, without processing history

Application · New telehealth brandUnderwritten merchant account

Owners: ID for each owner of 25% or more and one controller
Clinicians: Names, license numbers, states covered
Prescribing process: Assessment, synchronous visits, declines
Who sells what: Consult or membership; which pharmacy
Plan terms: Price, cycle, cancellation, before payment
Bank statements: Three months, the owner's
Site: Terms, refund policy, contact, company details

Illustrative record.

Clinicians, prescribing process and who sells what: the lines telehealth adds.

Illustrative example.

Your structure decides who signs the application: see who can own a telehealth company.

Requirements differ by provider

Providers don't agree on what a telehealth file needs. Read their requirements before you choose, and be ready for the strictest.

Provider	What it asks for telehealth	LegitScript
Stripe	License numbers and process information; approval "specific to each service offer" and revocable1 2	"Telemedicine businesses don't need certification from LegitScript"2
PaymentCloud	ID, signed application, voided check, three months of bank and of processing statements, business information3	Not stated on its page3
Corepay	Account review; "VIPPS certification or proof of LegitScript registration is required"4	Required4

Processing statements are the one item you won't have. Ask whether the provider accepts the owner's bank statements instead; several do for new businesses6.

A realistic path for a new telehealth company

Start with the consult or membership. Selling medication yourself puts you in the pharmacy rules: Visa Tier 1 for MCC 5122 and 59127. See consultation and medication billing.
Apply with your clinical file ready: licenses, states, process, a sample of your patient terms.
Disclose everything you sell. Stripe's approval is "specific to each service offer"1.
Keep disputes and refunds low from day one. Visa's fraud plus dispute threshold is 1.5% in the US since April 1, 202611.
Build three months of clean statements, then ask for a review of terms.
Add a second processor once you have recurring revenue: payment routing for telehealth companies.

Each step builds the history the next review reads.

Watch out

A launch campaign that multiplies volume overnight looks like a risk spike to a new account. Tell your processor before you scale ads.

What to hold back in the first months

Some offers are legal but read as risk on a new file. Wait until you have history.

Offer	Why wait
Auto-enrollment in a plan right after the intake form	The FTC alleges exactly this in its July 29, 2026 complaint against a telehealth company (FTC)8
Free or $1 trials into a treatment plan	Visa requires notice before a trial ends and online cancellation (Visa)9
Selling the medication on your own account	Pharmacy registration rules apply (Visa)7
Controlled substances	Federal flexibilities are temporary, through December 31, 2026 (DEA)10
Patients in states your clinicians don't cover	Your license list won't match your sales (Stripe)2

Tagada follows Visa and Mastercard rules and the laws that apply to payments.

If you do plan trials later: trial offers for telehealth companies.

Terms to expect, and how they improve

Term	At the start	After clean months
Reserve	5% to 10% held 90 to 180 days, per published ranges6	Ask for a review with your statements
Volume cap	A monthly limit6	Raised as volume matches projections
Payouts	Possibly delayed	Faster: see telehealth payout timing
Services	Only those declared1	New offers after review

Fig. 2How terms move after clean months

Reserve
5% to 10% held 90 to 180 days at the start, per published ranges6. Ask for a review with your statements.
Volume cap
A monthly limit6, raised as volume matches projections.
Payouts
Possibly delayed at first, faster after clean months.
Services
Only those declared1; new offers after review.

Low disputes and statements that match projections are what earn a review.

PaymentProviders.io, September 7, 2026; Stripe.

The cost side in detail: telehealth processing fees and reserves.

How Tagada helps

Payments for a new telehealth brand

TagadaPay reviews each file, with "enhanced review for regulated verticals"13, and keeps what you build portable: "Your PCI-tokenized cards, your customer profiles, your subscription data, all portable."

Fraud filters from day one: "Native 3DS2, device intelligence, and rules engine: approve real customers, block the rest."
Your vault, portable: "Switch processors without re-onboarding customers."
Routing across TagadaPay and processors such as Stripe, NMI and Airwallex, with a cascade to another processor when one is down or times out
People you can reach: "24/7 human support on Slack Connect"

Building the brand side: how to start and scale a telehealth company. Starting from scratch? Tagada Rx runs storefront, clinicians licensed in the patient's state, pharmacy and payments in one stack, and starts "with a small selected group of brands"12. US patients only, by selection.

Apply for processing

Updated on November 3, 2026

Nick Bonnassies

CMO at Tagada

CMO at Tagada. Before Tagada, Nick built direct-to-consumer brands that generated over $115M in sales, raised over $25M in crowdfunding and sold two of them. He also works as a fractional CMO on marketing operations and AI systems.

Frequently asked questions

Can I get a merchant account for a new telehealth company?

Yes. Underwriters rely on your owners' identity, your clinicians' licenses and your prescribing process, your plan terms and bank statements. Expect a reserve or a volume cap at first, reviewed after a few clean months.

Should a new telehealth company start on Stripe?

It can apply: telemedicine is restricted, not prohibited, and reviewed case by case. Approval covers the services you declared and can be revoked. Read does Stripe allow telehealth? before you rely on it alone.

Do I need LegitScript certification to get a merchant account?

Not for Stripe. Some high-risk providers require it, such as Corepay. Google and Meta require it for telehealth ads. Details: LegitScript for ads and payments.

What if I don't have processing statements?

PaymentCloud lists three months of processing statements, but new businesses often submit the owner's bank statements instead. Ask the provider before applying, and bring your clinical documentation to compensate.

How long until I get better terms?

Usually after a few months of steady volume and low disputes. Ask when the reserve and volume cap will be reviewed, and stay well under Visa's 1.5% threshold.