Funding for Businesses That Bill Insurance or Medicaid

Businesses paid mainly by third-party payers rather than by the patient at checkout: home health and home care agencies, physical therapy and ABA clinics, behavioral health and addiction treatment programs, medical and dental practices, labs, durable medical equipment suppliers, and ambulance and EMS services.

It fits best when reimbursement is steady but slow. It is not a fix for a practice whose claims are mostly being denied, or whose rates don't cover its costs.

Payroll covered through the reimbursement lag. Approval based on deposits and payer mix, not credit score. No real estate collateral. Funding that grows with billing volume. A direct funder that already works with healthcare and staffing businesses.

Payroll for nurses, aides, therapists and techs; bridging claims held up by prior authorization, denials or resubmissions; covering the gap while a new location is credentialed with payers; EVV, EHR and billing systems; supplies and equipment; opening a new service line or location.

Generally $50,000 or more in monthly revenue, most of it from insurance, Medicare, Medicaid or managed care, and an active business bank account. We look at deposit consistency, payer mix, and existing advances. Not all applicants qualify.

A fixed daily or weekly remittance, or a share of receivables, sized to your reimbursement cycle. Because it is a purchase of future receivables, not a loan, there is no fixed maturity date, and the reconciliation terms let the remittance be adjusted if collections fall.

Payer timing makes providers look strained on paper. Medicare generally pays clean electronic claims no sooner than 14 days and within about 30, Medicaid and managed care often take longer, and a denied claim can take months to resubmit and appeal. Home health agencies bill Medicare in 30-day periods, and Medicaid home care now requires electronic visit verification before claims pay.

Banks see thin cash, payroll-heavy costs, and little hard collateral, and they underwrite slowly. Factoring Medicare and Medicaid receivables is limited by anti-assignment rules. That leaves growing providers short on cash even when billing is strong.