Work / Healthcare · Fintech
Hamilton Pay: payment automation that kept healthcare practices paid on time
A healthcare payment platform that reconciled ACH and card flows, consolidated statements, and moved more than $100M a year for medical practices and their patients.

- annual payment volume processed
- $100M+
- patients across the platform
- 30K+
Context
The product
Hamilton Pay served healthcare practices whose revenue arrives through a mix of card payments, ACH transfers, and payer remittances — each with its own timing, fees, and failure modes.
Challenge
The problem worth solving
Practices were reconciling payments across processors and bank statements by hand. Money arrived, but matching it to patients and visits consumed staff time, and errors surfaced weeks later as accounting discrepancies.
Constraints
What the engineering had to respect
- Payment data demands exact, auditable accounting — approximations are not acceptable
- Patient billing context is sensitive healthcare information and must be handled accordingly
- Reconciliation had to fit the workflows practice staff already run every day
Contribution
What LaunchStacks did
LaunchStacks designed and built the platform across the stack — payment ingestion and reconciliation, statement consolidation, and the dashboards practice staff work in daily.
Solution
What shipped
- Automated reconciliation matching ACH and card settlements to patients, visits, and expected amounts
- Consolidated statements replacing per-processor exports with one auditable view
- Exception queues that surface mismatches for human review instead of letting them age into discrepancies
- Operational dashboards tracking payment timing, failures, and volume
Architecture
How it was built
- Next.js front end with a Node.js service layer on AWS
- Stripe integration for card flows alongside direct ACH processing
- Idempotent payment-event processing so retries and replays never double-count
- Append-only audit trail across every money-movement event
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