Professional Consultant and Broker Services

Medical Receivables Funding, also known as Factoring   

Medical Receivables are invoiced monies owed to health care providers, manufacturing companies, Durable Medical Equipment Companies (DME) by insurance companies or other third party payors such Insurance Companies, Medicare, or Medicaid.
Note: Typically, this does NOT include payments owed to health care providers by "patients."

How Are Medical Receivables Created?

Medical Receivables are created when a health care provider renders service or a manufacturer provides equipment to a patient and is waiting for reimbursement from an insurance company, HMO, PPO, or government source.

Who Can Benefit from the Sale of a Medical Receivable?

In the medical industry, it is not uncommon for repayment to take from 60 to 120 days. Delays in receiving payment create cash flow problems for physicians and other health care providers. Selling these receivables can help the provider of services or equipment stay current with payroll, taxes, overhead expenses, or other obligations.

Are you waiting to be paid by an insurance company, HMO, PPO, or government source such as Medicare or Medicaid? Contact us and let us explain how we can help get you the cash you need.

	Replace the paper value of your accounts receivable with cash
	We will wait so you don't have to be the one waiting, for insurance companies, HMO's, Medicare, Medicaid, Blue Cross/Blue Shield and other insurance carriers to make payments
	Our funding sources work hand-in-hand with your medical billing operations to alleviate billing delays and accuracy-in-processing issues.
	Customized medical equipment leases and sale-lease-back programs allow you to access hidden cash. These include everything from office equipment and furniture to medical scanners, dialysis machines, dental equipment…and more.

                                                           

Unlike bank lines that can tie up all of your assets, factoring involves only your third party medical claims

• No collateral other than accounts receivables
• No financial guarantees
• Unlimited amount of dollars

Factoring provides working capital without adding debt to your balance sheet. There is no predetermined maximum limit. This working capital arrangement is not limited in amount as many bank products are nor is it subject to banking "regulations."

What Factoring "Is Not:"
  * A Loan - Factoring is the sale of your medical claims for
    services already delivered   
   * Offered By Banks - Factoring is not an asset-based loan, nor 
    is it a debt facility similar to those offered by banks. 

Success By Design Capital, working with the industries foremost funding source, will arrange for an on site visit in   order to evaluate your systems and controls. Our funding source consultants will determine the amount that each insurance company pays for each procedure you or your business performs. Our funding source will purchase that portion of your billing which we call the "net collectible amount." 

Medical Receivables Valuation:
* An audit is performed to determine the "net" collectible value
* The "net collectible value" is the amount that will ultimately be paid by the third-party payor
* A percentage of the net collectible is factored 

The Audit:
* Determines the net collectible value
* Receivables reviewed by two segments:
       - third party payor
       - individual medical procedure (CPT Code)

The review of your facility "is not" a financial audit and is not designed to verify your financial statements. It will however, examine your billing practices, operational controls, and other activities pertaining to the processing of your insurance claims and general billing procedures.

The audit will determine your contractual allowances (the difference between your usual fee for a procedure and the amount which you have agreed to receive from the insurance carrier).

It will also provide us with a schedule of all of the rates paid by the insurance companies with whom you participate.

Example Audit:

 AETNA Insurance Co., Procedure ABC

 Charge                              $100.00

 Patient                              $  30.00

 Contractual Allowance        $  20.00 (discount)

 Due From AETNA             $  50.00 (net amount factorable)

 Why Factor?
* Third party payors are generally late payors
*  Accuracy of patient information
*  Accuracy of medical information
*  Timeliness of billing

Insurance payors have a slow and inconsistent payment record for paying medical claims. The abundance of information needed on the standard billing form makes the likelihood of error highly probable. Very often the individual responsible for billing has other duties that must also be addressed thus causing further delays in billing; this results in even slower and inconsistent payments.

Additional Perks:

Through our funding sources, we can extend the same cash flow facility to physicians and other providers that are currently being used by hospitals nationwide. In other words, physicians in their own practice can now avail themselves to the same funding strategy currently being utilized in the hospitals in which they have privileges.

Contact us today! We can will facilitate the purchase of your A/R's and get you the cash flow you need for growth and survival. You do not have to wait on Insurance Companies or 3rd party payors to obtain the cash flow you need. 


Contact Us Today!

Success By Design Capital
 
Telephone: 813-661-2201 Toll Free: 877-813-5578
Facsimile: 813-684-1463 Email: ASuccessByDesign@verizon.net

There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." .... Albert Einstein (1879-1955)