How you're losing thousands of dollars in fees on payments from international hospitals
· 5 min read
Introduction
Getting paid by an overseas hospital should not cost you a slice of the money you have already earned. Yet for most Indian medical value travel facilitators, every monthly payment from a hospital abroad arrives a few percent lighter than the invoice.
SWIFT wires and PayPal are still the default ways overseas hospitals pay Indian facilitators. Both work, but both charge 3 to 4% of the amount transferred. On a business that runs on referral fees, that is a much bigger share of your profit than it looks.
In this article, we explain how overseas hospitals pay MVTFs today, what those payments really cost, and how Pleny helps you keep more of what you earn.
Key takeaways
- How MVTFs earn: facilitators earn a percentage of what the patient pays the hospital, in India or abroad.
- How they get paid: overseas hospitals in countries like Turkey and Thailand usually send one batched payment a month, covering every patient referred.
- What it costs: SWIFT and PayPal take 3 to 4% of each payment. If 20% of your revenue is profit, a 3% fee wipes out 15% of that profit.
- The fix: Pleny lets MVTFs receive international payments with no forex markup, a FIRA with every payment and INR settlement within a day.
How do overseas hospitals pay MVTFs?
Overseas hospitals usually pay MVTFs once a month, in a single batched payment. That one payment covers the referral fees for every patient the MVTF sent that month.
What a monthly payment looks like
| Patient | Treatment | Hospital bill | Referral fee (20%) |
|---|---|---|---|
| Patient A | Knee replacement | $12,000 | $2,400 |
| Patient B | Cardiac surgery | $15,000 | $3,000 |
| Patient C | Cancer treatment | $23,000 | $4,600 |
| Monthly payment | $50,000 | $10,000 |
The batch keeps things simple for the hospital, but it also means a single fee on a single large transfer takes a noticeable bite out of the MVTF's month.
The hidden cost of getting paid
Today, most overseas hospitals pay MVTFs through SWIFT wires or PayPal. Both take 3 to 4% of the amount transferred before the money reaches your Indian bank account.
SWIFT wire transfers
- Sending and intermediary bank charges, often deducted from the amount you receive
- A forex markup when your bank converts the foreign currency to INR
- Settlement in 2 to 5 working days, and you may need to chase your bank for the remittance certificate
PayPal
- A 4.4% transaction fee on international payments, plus a fixed fee based on the currency
- A currency conversion markup on top
- A monthly FIRA summary instead of one per payment
Why 3% is bigger than it looks
A 3% fee sounds small, but it is charged on your revenue, not your profit. An MVTF still has to pay its coordinators, interpreters, airport pickups and marketing out of every referral fee.
Take the $10,000 monthly payment from above, and say 20% of it is profit after your costs:
| Amount | |
|---|---|
| Monthly referral payment | $10,000 |
| Profit after costs (20%) | $2,000 |
| Lost to a 3% transfer fee | $300 |
| Share of profit lost | 15% |
At 4%, the loss is $400, or 20% of your profit. That is money you earned and lost just in the process of receiving it. Over a year, a $300 monthly loss adds up to $3,600.
How Pleny helps MVTFs keep more of what they earn
Pleny is a platform for MVTFs to receive international payments at the lowest possible cost, with INR settled to your bank account within a day.
No forex markup
Pleny converts at live mid-market rates with no markup, so your referral fee is not quietly shaved during conversion.
Low, transparent fees
You see exactly what you pay before the money arrives, with no intermediary or correspondent bank charges deducted along the way.
Settlement within a day
Funds reach your Indian bank account in INR the next day, through RBI-authorised AD Category-I banks, instead of 2 to 5 working days.
FIRA with every payment
Every payment comes with its own FIRA, ready for your accountant and auditor, without a separate request to your bank.
Virtual accounts in 25+ currencies
Overseas hospitals can pay you in their own currency, whether they are in Turkey, Thailand or elsewhere, with 24/7 support across time zones.
Traditional methods vs Pleny: A quick comparison
| Feature | SWIFT wire | PayPal | Pleny |
|---|---|---|---|
| Cost of receiving | 3 to 4% in bank charges and forex markup | 4.4% + fixed fee + conversion markup | No forex markup, low transparent fee |
| FX rate | Your bank's rate | PayPal's rate | Live mid-market rate |
| Settlement time | 2 to 5 working days | Variable | Within a day |
| FIRA | On request from your bank | Monthly summary | With every payment |
| Currencies | Depends on your bank | Multiple | 25+ |
With Pleny, MVTFs can save the large share of profit they lose today just to get paid, and put it back into their balance sheets.
Ready to keep more of every referral fee? Get started with Pleny.
Frequently asked questions
What is a medical value travel facilitator?
A medical value travel facilitator helps foreign patients find affordable, quality treatment, by connecting them with doctors and hospitals and handling the logistics of their trip.
How do medical tourism facilitators make money?
Most MVTFs earn a percentage of the amount the patient pays the hospital. The hospital pays this referral fee once the patient's treatment starts.
How do overseas hospitals pay Indian facilitators?
Most overseas hospitals send one batched payment a month through a SWIFT wire or PayPal, covering every patient the facilitator referred that month.
How much does it cost to receive an international payment in India?
Through SWIFT or PayPal, it usually costs 3 to 4% of the amount, once bank charges, transaction fees and forex markups are added up.
What is the best way for an MVTF to receive international payments?
Pleny lets MVTFs receive international payments with no forex markup, a FIRA with every payment and INR settlement within a day.
Does a facilitator get a FIRA for every international payment?
With Pleny, yes, one per payment. With PayPal you get a monthly summary, and with a SWIFT wire you usually have to request it from your bank.