Primary Care

Primary Care Billing Cash Flow

Primary care runs on thin margins and high evaluation and management volume, yet UnitedHealthcare and Anthem reimburse on their own 30 to 90 day schedule while you cover staff, rent, and supplies.

The problem

Thin margins meet a 30 to 90 day wait.

UnitedHealthcare and Anthem can take 30 to 90 days to pay a 99214 claim, and Aetna and Cigna are rarely faster. Primary care lives on volume, so a slow cycle multiplied across thousands of E/M and wellness claims opens a persistent gap between the care delivered and the cash received.

While you wait, you are covering clinician and staff pay, rent, and supplies out of pocket.

Primary care payers, days to pay

UnitedHealthcare72 days
Anthem61 days
Aetna52 days
Cigna46 days

Commercial primary care claims reimburse on their own 30 to 90 day schedule, while you cover staff, rent, and supplies.

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 99214 is valued on its own merits rather than a portfolio average. The same holds for your annual wellness visits and CPT 99490 chronic care management, the first 20 minutes of clinical staff time per calendar month.

Every eligible primary care code is funded the next business day.

Codes Copay purchases

99213Office or other outpatient visit for the evaluation and management of an established patient, low level of medical decision makingEligible for purchase
99214Office or other outpatient visit for the evaluation and management of an established patient, moderate level of medical decision makingEligible for purchase
99215Office or other outpatient visit for the evaluation and management of an established patient, high level of medical decision makingEligible for purchase
G0438Annual wellness visit, includes a personalized prevention plan of service, initial visitEligible for purchase
How it works

How Copay works for your practice.

Your billing 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 EHR and payor relationships, and let eligible claims fund automatically.

See how the process works
01

Connect

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

02

Submit

Submit claims through your existing EHR exactly as you do today.

03

Get paid

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

Non-recourse

The wait on your claims is our risk, not yours.

Non-recourse means a denied eligible claim is Copay's loss, not yours. When a primary care claim is underpaid or denied after the fact, your capital is not clawed back, so a thin-margin practice stays covered every cycle.

See how non-recourse works

Related: explore Copay across clinical specialties.

Thin margins, covered every cycle

Claim 99214

UnitedHealthcare · $128.40

Awaiting payor

The wait on a single E/M claim is exactly the gap Copay closes.

Funded the next business day, before the payor ever closes its 30 to 90 day cycle.

Common questions

Primary care billing, answered.

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

Copay purchases eligible commercial primary care claims, including those billed to UnitedHealthcare, Anthem, Aetna, Cigna, Humana, and Blue Cross Blue Shield plans.

Copay purchases eligible evaluation and management visits, annual wellness visits, and chronic care management claims, including codes such as 99213, 99214, 99215, G0438, and 99490, priced individually at the service line.

Non-recourse means a denied eligible claim is Copay's loss, not yours. If an eligible purchased claim is denied or underpaid, Copay absorbs the loss with no clawbacks against your practice.

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

How Copay works for primary care practices

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 code99214

Office or other outpatient visit for the evaluation and management of an established patient, moderate level of medical decision making

PayerUnitedHealthcare
Billed$128.40

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

$3,200

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 primary care claims the next business day.

Copay purchases your eligible primary care claims. No loans, no personal guarantee, no workflow change.