Hospitals and Health Systems

Hospital and Health System Billing Cash Flow

You carry enormous receivables across inpatient, outpatient facility, and professional claims while UnitedHealthcare, Anthem, and Aetna sit on those balances for 45 to 75 days.

The problem

Large balances stack up across every service line.

Hospitals and health systems carry enormous accounts receivable across inpatient MS-DRG claims, outpatient OPPS and APC facility fees, professional claims, and ancillary services, all at once and across every payer.

Clinical documentation requirements, charge-capture audits, and medical-necessity reviews slow commercial outpatient payment well beyond 30 days, tying up large balances across service lines.

Explore care settings

Hospital payers, days to pay

UnitedHealthcare75 days
Anthem62 days
Aetna54 days
Cigna45 days

Commercial outpatient claims routinely sit 45 to 75 days while charge-capture audits and medical-necessity reviews run.

Service-line purchasing

Purchased at the code level, not blended.

Copay prices each claim individually at the service line, using how that specific code performs with your payor, so a 99285 emergency department facility claim is valued on its own merits rather than a portfolio average.

Inpatient stays paid under MS-DRG and outpatient services paid under OPPS and APC are each funded the next business day.

Codes Copay purchases

99285Emergency department visit for the evaluation and management of a patient, high level of medical decision makingEligible for purchase
93306Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording when performed, complete, with spectral and color flow Doppler echocardiographyEligible for purchase
70450Computed tomography, head or brain; without contrast materialEligible for purchase
99214Office or other outpatient visit for the evaluation and management of an established patient, moderate level of medical decision makingEligible for purchase
How it works

How Copay works for your health system.

Your revenue cycle team submits claims exactly as they do today. Nothing changes except when you get paid. Copay reads claim data at the clearinghouse layer, so there is no new software and no retraining.

Connect once, keep your billing software and payor relationships, and let eligible claims fund automatically.

See how it works
01

Connect

Connect your billing software once. Takes minutes, no IT ticket.

02

Submit

Submit claims through your existing billing software exactly as you do today.

03

Get paid

Capital lands in your account the next business day, by ACH.

Non-recourse

Large balances, funded across every service line.

Non-recourse means a denied eligible claim is Copay's loss, not yours. When a large outpatient claim is held in medical-necessity review or denied after the fact, your capital is not clawed back.

A 99285 emergency department facility claim billed to UnitedHealthcare can be purchased non-recourse and funded the next business day, alongside the rest of your service lines.

See how non-recourse works

Large balance, absorbed

Claim 99285

UnitedHealthcare · $685.00

In review

A large balance under medical-necessity review is exactly the gap Copay closes.

Funded the next business day, before the payor ever resolves the review.

Common questions

Hospital and health system billing, answered.

No. Copay is not a loan, not factoring, and not a merchant cash advance. Copay purchases your eligible hospital and health system claims outright and deposits funds the next business day, with no debt and no repayment schedule.

Copay purchases eligible commercial hospital claims billed to UnitedHealthcare, Anthem, Aetna, Cigna, Humana, and Blue Cross Blue Shield plans, across inpatient, outpatient facility, and professional service lines.

Yes. Copay purchases eligible inpatient claims paid under MS-DRG, outpatient facility services paid under OPPS and APC, and the professional claims that accompany them, so balances across every service line are funded the next business day.

No. Copay advances capital on eligible claims regardless of how slowly the payor adjudicates. Charge-capture audits, clinical documentation requirements, and medical-necessity reviews are exactly the cash flow gap Copay closes.

No. Your revenue cycle team submits claims exactly as it does today through your existing billing software or clearinghouse. Eligible claims are funded the next business day.

How Copay works for hospitals and health systems

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

CPT code99285

Emergency department visit for the evaluation and management of a patient, high level of medical decision making

PayerUnitedHealthcare
Billed$685.00

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

Funds wired to your account, next business day

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 hospital claims the next business day.

Copay purchases your eligible hospital and health system claims. No loans, no personal guarantee, no workflow change.