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Guide · October 2026
Insurance reimbursements are slow — how can my practice get cash flow funding?
Fund the gap with working capital or a line of credit sized on your practice’s bank deposits, not on your claims. MedStream Capital underwrites both in-house — $25,000 to $2,000,000 in working capital or a $25,000 to $500,000 line — with a decision the same business day and funds 24 hours after a signed contract. Practices bridging an insurance receivable cycle typically borrow $40,000 to $250,000.
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Slow reimbursement is a timing problem, not a solvency problem
A practice books revenue the day it delivers care and collects it weeks or months later. Commercial clean claims commonly pay in 14 to 45 days. Medicare holds electronic claims behind a 14-day payment floor. Medicaid and managed-care clean claims run 30 to 45 days, and a denial or an EVV mismatch pushes that to 60 to 90 days or more. Personal-injury and attorney-lien files can take 6 to 18 months. Payroll, rent and supplies do not wait for any of it.
The benchmark most practices are measured against is 30 to 40 days in accounts receivable, with anything above 50 days treated as a warning sign. If your days in A/R are drifting past that line, the practice is not failing — the cash is just sitting at the payer. Cash flow funding puts it in your account now and lets the claims repay it as they land.
Why we underwrite deposits instead of claims
MedStream Capital is not a HIPAA covered entity and not a business associate. On working capital and a line of credit we read four months of business bank statements and five things in them: average monthly deposits, the number of deposits per month, the lowest daily balance, negative days, and any existing advance being debited. We never ask for claim detail, patient names or procedure codes, and we do not connect to your EHR, practice management system or clearinghouse. Your payer mix already shows up in your deposits, which is why a complete file received before 2:00 p.m. ET gets a decision the same business day.
Claims factoring is the one exception. Advancing against billed claims requires claim-level detail that can be protected health information, so MedStream Capital does not underwrite it in-house. It is placed with a specialist partner that operates under a Business Associate Agreement you sign directly with that partner.
What you’ll need
- Four months of business bank statements, linked or uploaded as PDFs
- Business legal name, EIN, address and entity type
- An active state professional or facility license for the practice or its supervising provider
- A U.S. business checking account in the practice’s legal name
- A list of any advance or loan already being repaid
- The amount you need, and the date payroll or the payer backlog hits
No tax returns, no P&L, no patient records.
Side by side
Four ways to fund a slow-paying receivable.
| Option | Underwritten by | Amount | Speed | Main requirement | Best when |
|---|---|---|---|---|---|
| Working capital | MedStream Capital, in-house | $25,000 – $2,000,000, 3 – 24 months | Same-day decision, funded 24 hours after signing | $15,000/mo deposits, 6 months, no FICO minimum | One lump covers a backlog or a payroll stretch |
| Line of credit | MedStream Capital, in-house | $25,000 – $500,000, revolving | Same-day approval; draws settle next business day | $20,000/mo deposits, 6 months, no FICO minimum | The gap comes back every month or every season |
| Claims factoring | Specialist partner, under a BAA | 80% – 90% of billed claims; facilities $25,000 – $5,000,000 | 7 – 14 days to set up, then 24 – 48 hours per batch | $50,000+/mo in billed receivables | A large claim book that keeps growing |
| Partner term loan | A partner bank | $50,000 – $5,000,000, 1 – 5 years | 2 – 4 weeks | 24+ months, 600+ FICO, two years of returns | You have time and want a monthly payment |
Line or lump: how to choose
If the gap is a single event — a backlog after a clearinghouse switch, a new clinician waiting 60 to 120 days on credentialing, a quarter where denials spiked — a fixed working capital advance is the simpler tool. One published example: a medical practice 12 years in business, depositing $240,000 a month, took a $185,000 advance over 12 months to carry payroll through a clearinghouse migration.
If the gap comes back every cycle, a line of credit charges you only for the weeks you are out. We size a line at one to one-and-a-half months of average deposits, capped at $500,000, so a practice depositing $140,000 a month typically sees a line of $140,000 to $200,000. There is no fee to keep it open and unused.
What it costs
Working capital is priced as a fixed total cost in dollars, known on day one, and repaid daily or weekly on your deposit cycle. On our $154,000 worked example over 12 months, total payback runs $185,000 to $200,000 at typical pricing for an established practice — roughly $3,700 a week. Pay it off early and up to 30% of the remaining balance comes off; there is no prepayment penalty, ever. Your actual pricing is set at underwriting.
Factoring is priced per invoice by days outstanding, so a book that collects in 35 days is cheap and one that collects in 95 days is not. If you would rather nobody touched your claims at all, working capital does the same job off bank statements alone.
Related: working capital, line of credit, claims factoring, how much a practice can borrow, the reference guides, or what we do and do not see.
FAQ
Questions that usually follow.
Can my practice get funding while waiting on insurance reimbursements?
Yes. MedStream Capital working capital and lines of credit are underwritten on your business bank deposits, not on your open claims. You need 6 months in business and $15,000 a month in deposits, and there is no minimum credit score. Complete files received before 2:00 p.m. ET get a decision the same business day, and funds wire 24 hours after a signed contract.
Do you need to see my claims or patient information?
No. MedStream Capital is not a HIPAA covered entity and not a business associate. We read four months of business bank statements and nothing clinical, and we do not connect to your EHR, practice management system or clearinghouse. Only claims factoring uses claim-level detail, and that is handled by a specialist partner under a Business Associate Agreement you sign with them.
Is claims factoring or working capital better for slow insurance payments?
Factoring advances 80% to 90% of billed claims and needs $50,000 a month or more in billed receivables, with 7 to 14 days of setup. Working capital is a fixed amount from $25,000 to $2,000,000, priced once in dollars, funded in 24 hours, with no claim data involved. Most practices that call about factoring end up on working capital.
How much do practices borrow to bridge slow reimbursements?
Bridging an insurance receivable cycle of 30 to 90 days typically runs $40,000 to $250,000. A payroll gap against a Medicaid or managed-care claim cycle typically runs $50,000 to $300,000. The full in-house range is $25,000 to $2,000,000.
Does applying affect my personal credit score?
No. MedStream Capital runs a soft pull at application, which does not affect your personal credit score. Any hard pull happens only with separate written consent before funding.
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