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Working Capital, Invoice Financing, Asset-Based Lending. Each has its own page listing the funders in this directory that offer it and what each one publishes about its terms.

Is this specific to healthcare?

It is written around how a healthcare business actually generates and collects cash, which is what makes its funding problem different. The mechanics transfer; the arithmetic may not.

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How payer mix sets the advance rate on medical receivables

Two practices with the same gross charges can be offered facilities that differ by a third, because a dollar billed to a commercial plan and a dollar billed to a patient are not the same dollar.

By Find Me Funders research desk Updated 14 September 2026 1028 words 5 min read

Drafted with AI assistance. Not yet independently checked. Nobody has verified the claims on this page against a source, so treat the figures and legal points as a starting point rather than as settled, and confirm anything you are about to act on. How we check things.

A practice billing 100,000 a month in gross charges does not have a 100,000 receivable. It has a claim against several different payers, each of which will pay a different fraction of the charge, on a different timetable, with a different probability of paying nothing. The advance rate you are quoted is a compressed summary of that mix, and it is the number to argue about.

Illustrative only —take 100,000 of monthly gross charges split 45 per cent commercial, 30 per cent Medicare, 15 per cent Medicaid, 10 per cent self-pay. Apply net collection rates against charges of 55 per cent commercial, 40 per cent Medicare, 25 per cent Medicaid and 8 per cent self-pay:

Commercial: 45,000 charged, 24,750 expected
Medicare: 30,000 charged, 12,000 expected
Medicaid: 15,000 charged, 3,750 expected
Self-pay: 10,000 charged, 800 expected

Total expected collections: 41,300, or 41.3 per cent of gross charges. A funder advancing 80 per cent of expected net realisable value funds 33,040 — which is 33 per cent of the gross charges you put on the application. When a practice says "they only offered me a third of my billings", this is usually what happened. The 80 per cent was never applied to the number the practice had in mind.

Now shift the mix. Move commercial to 35 per cent, Medicare to 25 and self-pay to 25, holding the collection rates constant. Expected collections fall to 35,000, and the same 80 per cent advance produces 28,000. The practice did not get smaller. It added 5,040 a month of unfunded receivable by changing who walks through the door.

The four payer categories and what each does to the file

Commercial plans.Highest net realisation, most predictable timing, and the category that carries the most contractual variance — the same CPT code pays differently under each contract. A funder will want your fee schedules or at least a 12-month payment history by payer to build the realisation assumption rather than accept yours.

Medicare.Rates are published and stable, denials are procedural rather than discretionary, and timing is reliable. Underwriters like it. What they do not like is the assignment rule: Medicare payment generally must go to the provider or to a permitted party, and reassignment of the right to payment is restricted. See the reassignment rules at 42 CFR 424.80. The practical consequence is structural, not fatal.

Medicaid.Lowest realisation, slowest cycle in many states, and often subject to managed-care intermediaries whose timing behaves nothing like the state's. Medicaid also has its own anti-reassignment rule at 42 CFR 447.10. State programmes differ substantially; a rate and a lag that hold in one state say little about the next.

Self-pay and patient responsibility.The category that has grown with high-deductible plans and the category funders discount hardest. Patient balances after adjudication behave like consumer receivables, and a facility will usually make them entirely ineligible rather than price them.

Why the structure is a lockbox, not an assignment

Because federal and state rules restrict reassigning the right to be paid, medical receivables financing does not usually work by the funder becoming the payee. It works by the payments continuing to flow to the provider, into a designated account the funder controls through a deposit account control agreement or a lockbox. The provider still owns the claim and is still the payee of record; the funder controls the account the money lands in.

Two things follow that surprise people. First, you will be asked to move your entire payer remittance stream, including electronic remittance setups, to the new account — a several-week administrative job that has to be planned around your billing cycle. Second, if any payer keeps sending money to the old account, you are contractually obliged to sweep it, and failing to do so is usually an event of default regardless of intent.

The four numbers that set your advance rate

Ask the funder which of these they are using and what value they assigned.

Net collection rate by payer, measured over at least twelve months. Not your gross charge, not your expected allowable — what actually landed, divided by what was billed.
Days in accounts receivable by payer, and the share of AR over 90 and over 120 days. Ageing buckets drive ineligibility more than the payer category does.
Denial and take-back rate. Retroactive adjustments, recoupments and audit take-backs reduce collections after the fact. A funder models this as dilution and it comes straight off the advance rate.
Concentration. One plan at 55 per cent of your billings creates the same single-point exposure as one customer would in any other industry. Expect a concentration cap.

What actually moves the number

Improving the mix is a years-long clinical and contracting decision, so start with the things inside your control this quarter.

Clean the ageing. Write off what will not pay. A funder computing dilution on an AR file stuffed with three-year-old self-pay balances will assume the whole file behaves that way.
Fix the front desk. Eligibility verification and point-of-service collection move dollars out of the self-pay bucket, which is the bucket with the 8 per cent realisation in the example above.
Produce a payer-level collection report, not a practice-level one. If you hand an underwriter a single blended number, they will apply their own conservative assumption to the whole file. If you hand them commercial at a documented rate, that slice gets priced on its own.
Ask for the ineligibles list in writing before you sign. Which ageing bucket, which payers, what concentration limit, how patient balances are treated, and whether credit balances are netted against availability.

What to refuse

Refuse a facility that quotes an advance rate without telling you what it is a percentage of. "Eighty per cent" against gross charges, against net realisable value, and against the funder's own estimate of net realisable value are three different offers, and only the last one is what you will actually draw. Get the base defined in the term sheet, in writing, with a sample borrowing base certificate filled in using your own last month's numbers.