Waiting on Insurance Payments: How Medical Practices Can Cover the Gap

A full appointment book does not mean the money is already in your bank account. A practice may have paid its staff and bought supplies while payment for those visits is still outstanding. Before filling that gap with business funding, find out what is owed, what is likely to arrive, and what needs attention from your billing team.

Find out why payment is still outstanding

Start with a current accounts receivable report. Accounts receivable, often shortened to A/R, is money owed to the practice. Separate unpaid insurance claims from patient balances, then review the insurer, amount, age and current status of each claim.

A submitted claim is not the same as a paid claim. Check whether it was received, whether it was rejected or denied, and whether anyone is responsible for the next step. The American Medical Association recommends monitoring payer decisions and regularly reviewing accounts receivable reports. Incomplete or incorrect claims can delay reimbursement.

Give each unresolved item an owner and a next action. Ask your billing team to check the applicable payer requirements and filing or appeal deadlines. Funding does not correct a coding mistake or turn a disputed claim into a confirmed payment.

Do not let one average hide the problem

Days in A/R measures the average time a practice takes to collect payments due. The American Academy of Family Physicians identifies it as one of several useful revenue-cycle measures, alongside collection and denial rates. It is a starting point, not a promise about when a particular insurer will pay.

Look beyond the average. One slow payer or a group of old claims can be hidden inside an otherwise reasonable total. Compare claim ages and payer patterns with your own records. Keep disputed or uncertain amounts separate from receipts you have a sound reason to expect.

Match essential costs to realistic receipts

List the costs due before the next expected collections: payroll, rent, supplies, insurance, taxes and existing funding payments. Use expected payment dates rather than the date of the patient visit or the full amount originally billed.

For a fictional example, suppose a practice has $18,000 available and expects $22,000 in collections before $32,000 of essential bills fall due. That leaves $8,000. If $10,000 of those collections arrives later, the same period has a $2,000 shortfall instead. These figures are planning examples, not typical practice results.

Talk through the timing with your practice manager, billing team and accountant. Check what can be postponed without harming patient care or missing an obligation. Do not assume that every unpaid claim will arrive together.

Use funding only with a clear repayment plan

Business funding may help cover a timing gap, but it adds a payment of its own. Compare the amount the practice receives, the total amount it must pay, payment frequency and the agreement's other terms. Test whether those payments still fit if the expected insurance receipts arrive later.

A recurring shortfall needs a closer look at collections and operating costs, not an automatic new funding commitment. Do not treat new funding as proof that the underlying billing problem is fixed.

Where Zippi fits

Zippi funds businesses directly. Its published minimum requirements include at least $20,000 in gross sales every month, at least 12 months in business and a business bank account. Prepare your most recent three to four months of business bank statements when exploring an application.

Review the actual offer and agreement before accepting. Repayment may be a fixed daily or weekly amount, or a share of daily or weekly sales. The payment schedule needs to work for your practice's cash flow, including slower collection periods.

See Zippi's medical practice funding page for practice-specific information, or its Dental Practice funding page if you run a dental office.

Medical practice funding · Dental Practice funding

This article is general educational information, not medical billing, legal, tax or financial advice. Claim requirements and funding terms vary.

Article sources

AAFP: Managing practice finances · AMA: 8 keys to improve revenue cycle management