An orthodontist can collect monthly payments with GoHighLevel's Send Recurring Invoice action, billed to a card stored after the first payment. The bottom line: the billing is simple, but a written plan with more than four installments can make the practice a creditor under the federal Truth in Lending Act, so the plan needs the right disclosures, or the practice should use outside financing.
The Truth in Lending question
Regulation Z, which implements the Truth in Lending Act, defines a creditor as a person who regularly extends consumer credit that is subject to a finance charge or is payable by written agreement in more than four installments, not including a down payment, and to whom the obligation is initially payable. Credit with no interest still counts if it is payable by written agreement in more than four installments. Regulation Z commentary and training materials describe regularly as more than 25 extensions of credit in the preceding or current calendar year for credit not secured by a dwelling. A written, say, 24 month payment plan with a down payment that a practice offers to more than 25 families a year fits that description. Creditors must provide credit disclosures, including the finance charge and the payment schedule, in the form the regulation requires.
This is general information. Whether a particular orthodontic plan is covered depends on the facts, so ask counsel before launching an in house plan, and consider third party financing that carries its own disclosures.
Payment options compared
| Option | Strength | Weakness |
|---|---|---|
| Full payment up front | No credit issue | Large payment, which some families cannot make |
| Down payment plus up to four installments | Outside the more than four installments test, if no finance charge | Large payments |
| In house plan over more than four installments | Convenient for families | May make the practice a creditor, with disclosures |
| Third party patient financing | Provider receives payment, lender handles credit | Fees, and a separate application |
What GoHighLevel documents
GoHighLevel's help page on recurring invoices says the Send Recurring Invoice action needs an invoice template under Payments, then Invoices, and a connected gateway, is currently supported for Stripe connected sub accounts, stores the card only after the first invoice is paid manually, and works with a Payment Failed trigger to retry and notify the customer.
GoHighLevel's help portal says accounts are not HIPAA compliant by default, and that HIPAA Compliance is a paid upgrade, $297 a month as an account wide add on, that must be enabled for the agency and then configured for the sub accounts that need it. Third party guides add that the add on provides a business associate agreement, encryption, audit logging, and multi factor authentication, that the practice also needs its own agreement with the agency, and that GoHighLevel itself recommends avoiding protected health information in SMS and email even with the add on. Whether the AI features are covered by the agreement is a question to put to HighLevel in writing before any patient data reaches them.
Build it in GoHighLevel
- Decide the plan structure with counsel first: the down payment, the number of installments, and whether any fee or interest applies.
- Put the plan in a written agreement that the family signs, using Documents and Contracts, with the schedule, amounts, due dates, late fee if any, and what happens if the patient transfers or stops treatment.
- Create an invoice template for the monthly amount, and send the first invoice for the down payment so the family pays it manually and the card is stored.
- Build a workflow with the Send Recurring Invoice action on the monthly schedule, with the number of payments from the agreement.
- Build a workflow with the Payment Failed trigger that texts a link to update the card and creates a task for billing.
- Add a reminder 3 days before each due date, generic wording, and a final balance notice before the last payment.
Worked example
For example, a $5,400 treatment with a $1,000 down payment leaves $4,400, paid over 24 months at $183.33 a month (4,400 divided by 24). That is 24 installments, more than four, so a written agreement for it is the kind of plan to review under Regulation Z. With 8 percent of cards failing in a month, a practice with 100 active plans sees 8 failures (100 times 0.08), each triggering a same day text.
Mistakes to avoid
- Offering the plan without checking Regulation Z. More than four installments in writing can make you a creditor.
- No written schedule. The agreement should state amounts and dates.
- No transfer or refund terms. Families move, and state law may regulate refunds.
- No failed payment alert. Add the trigger.
How this was handled before
Orthodontic offices ran in house payment plans with coupon books, then automated card billing. Regulation Z has applied to plans over four installments since long before text links, which is why the written agreement matters.
What to measure after launch
Track active plans, payments on time, failed payments, and plans that need a card update. Reconcile payments against the practice system monthly.
Check before you switch it on
US text messages sent from a standard 10 digit number need A2P 10DLC registration. The HighLevel support portal says registration is required for texts to US recipients from 10 digit long code numbers and that toll free numbers do not require it. HighLevel's opt in guidelines also say a person cannot be forced to agree to text messages in order to submit a form, so keep the consent box optional. One compliance guide separates informational texts, which need documented consent, from marketing texts, which need prior express written consent. Ask your attorney which category your reminders fall into. Have counsel review the payment plan agreement, the disclosures, and any refund rules before offering it. This is general information, not legal advice.
Questions people ask
Can an orthodontist bill monthly through GoHighLevel?
Yes, with the Send Recurring Invoice action for Stripe connected accounts, once the first invoice is paid manually to store the card.
Does a payment plan with no interest need disclosures?
Regulation Z covers a creditor who regularly extends credit payable by written agreement in more than four installments, even with no finance charge. Ask counsel.
When does a practice extend credit regularly?
CFPB and training materials describe it as more than 25 times in the preceding or current calendar year for credit not secured by a dwelling.
Ready to try it yourself? Start a GoHighLevel account here.
You can also see this in action in our GoHighLevel capabilities demo.