72-hour migration to a direct merchant account.
Stripe, Square, and PayPal issued blanket terminations across compounded GLP-1, HRT, peptide, and prescription telehealth starting Q1 2025 after the FDA declared the semaglutide (Feb 21, 2025) and tirzepatide (Dec 19, 2024) shortages resolved. Reserves are held 90 to 180 days. Recurring subscription revenue is bleeding every day the payment link is dead.
Hour 0 to 4: intake and document collection. Hour 4 to 24: pre-review packaging the file the way each acquirer wants to see it. Hour 24 to 48: submission to the acquirer with strongest vertical appetite. Hour 48 to 72: gateway setup, subscription re-tokenization plan, dispute defense configuration.
LegitScript healthcare merchant certification (2,150 dollars annual plus 975 dollars initial telemedicine review, 4 to 8 weeks) runs in parallel with the merchant account application, compressing time-to-first-batch. You do not wait for LegitScript to finish before starting processing at the new acquirer.
Payout-in-transit balance releases the next business day. Reserve hold is 90 to 180 days depending on dispute exposure and termination reason. Acceptable-use-policy terminations with clean dispute history release closer to 90; excessive-dispute or fraud terminations hold the full 180.
Stripe tokens do not transfer. Re-tokenization with Visa Account Updater and Mastercard ABU at the new gateway recovers 65 to 85 percent of pre-termination MRR within 30 days, plus 5 to 10 percent additional in months 2 and 3 via smart retry logic on soft declines.
Verifi RDR and Ethoca alerts resolve disputes pre-chargeback. Structured representment wins 40 to 60 percent on the remaining chargebacks. 3DS 2.0 shifts fraud liability to the issuer. Combined levers keep the new account under 0.6 percent with buffer, not at 0.9 percent with no margin.