Ambulatory Surgery Center Billing Cash Flow
Your facility-fee balances sit unpaid past 30 days under commercial package pricing and bundling rules, while you have already paid for the OR, implants, and staff.
Where your facility-fee cash goes, and how Copay closes the gap.
Prior authorization clears and the case is scheduled
The payer approves the procedure and your team books the OR block, so the surgical case is ready to run.
Prior authorization
Aetna · Case 66984
You perform the case and bill the facility fee
Your team submits the facility-fee claim through your existing billing software, separate from the surgeon's professional fee.
Claim 66984 facility fee
Aetna · $1,450.00
Payers review package pricing and implant documentation
Commercial payers apply package pricing and bundling rules and request implant invoices, so adjudication on complex cases runs well beyond 30 days while you have already paid for the OR, implants, and staff.
Copay pays the next business day
Copay purchases the eligible claim and deposits the capital the next business day, by ACH.
Deposit from Copay
ACH · Next business day
The surgery center facility-fee codes Copay purchases.
Copay prices each facility-fee claim individually at the service line, using how that specific code performs with your payer, rather than a blended portfolio average.
Every eligible surgery center code, from cataract and knee arthroscopy to GI cases like 45380, is funded the next business day.
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique
PurchasedArthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage, same or separate compartment(s), when performed
PurchasedEsophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple
PurchasedInjection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, single level
PurchasedCapital that fits the way surgery centers actually run.
Implants and OR
Cover implant and OR costs during review.
You have already paid for OR time, implants, and staff before the claim is even adjudicated. Copay funds the eligible facility-fee claim the next business day so those costs are covered while the payer works.
Large balances
Big facility-fee balances, funded at once.
Complex surgical cases carry large facility-fee balances that can sit unpaid for weeks. Copay purchases the eligible claim and funds the full balance the next business day, not in pieces.
Non-recourse
A denied claim is our risk, not yours.
Non-recourse means a denied eligible claim is Copay's loss. If a purchased facility-fee claim is denied after the fact, your capital is not clawed back.
Surgery center billing, answered.
No. Copay is not a loan, not factoring, and not a merchant cash advance. Copay purchases your eligible surgery center claims outright and deposits funds the next business day, with no debt and no repayment schedule.
Your center bills a facility fee that is separate from the surgeon's professional fee, and on complex surgical cases that balance can be substantial. Commercial payers apply package pricing, bundling rules, and implant-invoice documentation requirements, so adjudication often runs well beyond 30 days. Copay purchases your eligible facility-fee claims and funds them the next business day, so big balances do not sit unpaid while you have already paid for the OR, implants, and staff.
Surgery center revenue runs heavily through commercial plans such as UnitedHealthcare, Anthem, Aetna, Cigna, Humana, and BlueCross. Copay purchases eligible facility-fee claims billed to those payers, so the next-business-day deposit covers the bulk of your center's case volume.
Copay purchases the facility-fee claim that your center bills, which is separate from the surgeon's professional fee. Eligible facility-fee claims for procedures such as 66984, 29881, 43239, 64483, and 45380 are funded the next business day, regardless of how the professional component is billed.
Non-recourse means a denied eligible claim is Copay's loss, not yours. If an eligible purchased facility-fee claim is denied or downcoded after the fact, Copay absorbs the loss with no clawbacks against your surgery center.
From submitted claim to funded account.
While insurance takes 30 to 90 days, Copay moves in one.
Step 01 · Submit
You submit your claims as normal
Nothing changes about how your billing team works.
Claim #18473
DOS 02/04/24
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure)
Step 02 · Verify & Price
We verify and price in real time
Copay checks payor history and prices the claim at the CPT level.
Underwriting in progress
Step 03 · Approved
Advance approved
Capital is approved and scheduled for next business day deposit.
Advance Approved
$9,000
Net advance
Step 04 · Funded
Capital in your account
While the payor takes 30 to 90 days, you already have your capital.
Your account
$0
Available balance
Copay reconciles automatically when the payor pays. You do nothing.
Get paid on your surgery center claims the next business day.
Copay purchases your eligible surgery center claims. No loans, no personal guarantee, no workflow change.