Collections, not charges
Gross charges are a wish list. Net collections, the collection ratio and days in accounts receivable show what the practice actually banks and when.
Lines in 3 daysEquipment to $2MAcquisition capital
Practice financing underwritten on collections, not just the owner's credit score.
Physicians, dentists, veterinarians, therapists and clinic owners run businesses with a cash cycle most lenders misread: insurance pays in 30 to 90 days while payroll, rent and supplies are due now. Qualified Commercial finances practices on collections, payer mix and provider productivity. Working capital lines, equipment financing for imaging and clinical systems, and capital to acquire, start or expand a practice, processed by our own underwriters.
Screen before applying: 1+ year in business, $50K+ annual revenue and 640+ owner credit. Startup practices are reviewed on the provider's history, the lease and a credible ramp. Equipment requests need a vendor quote.
Four things a credit desk looks at in a practice file.
A practice's revenue is a claim before it is a deposit. The review follows the claim from service to collection, because that is the real cash cycle.
Payer mix
Commercial, Medicare, Medicaid, cash and membership revenue each pay on a different clock. A mix that skews slow argues for a line of credit sized to the lag.
Provider productivity and capacity
Revenue per provider, schedule utilization and room capacity say whether growth needs a hire, a room or a machine, and whether the new payment is earned.
Owner compensation and add-backs
Practices often run lean on paper. Owner draws, one-time costs and depreciation are normalized so cash flow is read as it is, not as the tax return shows it.
The six requests we see most from practice owners.
Each one maps to a different structure. Matching the structure to the cash cycle is what keeps the practice comfortable through a slow insurance month.
Working capital through the collections lag
Payroll, rent and supplies while claims are outstanding. A revolving line to $250K that is drawn in the gap and repaid when the payers clear.
Imaging, lasers, chairs and clinical equipment
CBCT, ultrasound, dental chairs, sterilization, lab and diagnostic systems. Financed on the asset from $25K to $2M over 24 to 84 months, with installation and training as soft costs.
Practice acquisition, goodwill included
Buying a retiring provider's practice where most of the price is patient relationships. Government-backed and structured terms that account for intangible value.
Startup practice, from lease to first patient
Build-out, equipment and the working capital to carry the ramp. Reviewed on the provider's production history and a credible schedule, not on a business that does not exist yet.
A second location or added operatories
Expansion capital in one structured facility: build-out, equipment and staffing runway together, sized against the existing location's proven collections.
Consolidating practice debt
Equipment leases, a credit card build-up and a short-term advance replaced with one fixed payment the collections can carry.
The practice programs, side by side.
Typical amount, term and time to close on a complete file. The file is matched to the program that fits; you do not have to pick first.
Main Street
6 programs| Program | Amount | Term | Typical close |
|---|---|---|---|
| Lines of Credit | to $250K | Revolving | 3 days |
| EZ Term Loan | $25K – $500K | 3–5 yr | 5 days |
| Equipment FinancingAll industries | $25K–$2M | 24–84 mo | File review |
| Hybrid Term / LOC | to $25M | Varies | 1 day |
| SBA 7(a)All industries | to $5M | 10–25 yr | 30 days |
| MicroCap Working Capital | $15K – $50K | 10 yr | 30 days |
Amounts, terms and timelines are typical ranges for complete files and are subject to underwriting, collateral review, documentation, third-party reports and lender approval. Nothing here is a commitment to lend. SBA programs are additionally subject to SBA eligibility and approval.
Days to close, by program.
Conventional pathQualified Commercial
Hybrid Term / LOC
1 day
Conventional
21 days
Lines of Credit
3 days
Conventional
14 days
EZ Term Loan
5 days
Conventional
30 days
SBA 7(a)
30 days
Conventional
75 days
MicroCap Working Capital
30 days
Conventional
75 days
See which review should happen first.
Four non-personal questions. The result is a routing recommendation, not an approval, and nothing is stored.
Step 1 of 425%
This check collects no personal details and does not make a credit decision.
Capital the schedule can carry.
The strongest practice files tie the money to production: a room that books, a machine that bills, a provider who has patients waiting.
Strong cases
- Equipment that adds a billable service already in demand
- A line that bridges a documented 45-to-90-day payer lag
- An acquisition where the seller's collections are verifiable and stable
- Expansion backed by a full schedule and a waitlist
Weak cases
- Technology bought for a service line with no referral base yet
- Covering falling collections caused by a payer or credentialing problem
- A startup with no production history and no lease in hand
- Stacking a short-term advance on top of an equipment lease and a line
What a practice file needs.
The business documents every commercial lender asks for, plus the three reports that make a practice legible to a credit desk.
The business
- Business tax returns, most recent 2 years
- Business bank statements, last 6 months
- Year-to-date P&L and balance sheet
- Business debt schedule, including equipment leases
The practice reports
- Production and collections report, trailing 12 months
- Accounts receivable aging by payer
- Payer mix summary
- Provider schedule or utilization summary
When acquiring or starting
- Letter of intent or purchase agreement
- Seller's tax returns and production reports
- Lease or letter of intent for the space
- Provider CV, license and credentialing status
From a slow payer month to a funded practice in four steps.
Direct underwriting removes the packaging, shopping and re-requesting that cost a brokered file a month.
- 01
Start the file
Pick professional and medical practice, answer a short set of questions and upload the reports you already run. A preliminary read comes back in minutes.
- 02
Underwriter review
The person who decides reads collections, payer mix and the schedule together, and asks for gaps once.
- 03
Written terms
Amount, term, payment, collateral and conditions on one sheet. Compare it against the production the money is meant to add.
- 04
Close and fund
Vendor paid directly on equipment; working capital lands in the operating account. Lines are ready to draw before the next payroll.
The healthcare practice library.
How lenders underwrite a practice: collections and payer mix, acquisitions with goodwill, startup funding and clinical equipment finance.
- Healthcare Practices
How Lenders Underwrite a Medical or Dental Practice
A practice has strong margins and almost no collateral. Here is the metric stack a credit desk builds instead, and the order it builds it in.
- Healthcare Practices
Collections and Payer Mix: What They Tell a Credit Desk
Net collection rate, days in AR and who actually pays you are read as risk signals, not operations metrics. Here is how an underwriter interprets each one.
- Healthcare Practices
Financing a Practice Acquisition, Goodwill Included
Most of a practice purchase price is intangible. How a lender tests the price against collections, funds the goodwill, and structures around transition risk.
- Healthcare Practices
Equipment Finance for Clinical Practices
Imaging, chairs, lasers and software all get financed differently. How structures compare, what soft costs to include, and the payback math worth running first.
Practice financing questions.
Can a new practice get financing before it has patients?
A startup practice is reviewed on the provider's production history at a prior employer, the lease, the build-out budget and a credible ramp. It is a harder file than an established practice and it leans on the provider's own track record.
How is a practice acquisition with mostly goodwill financed?
Government-backed programs such as SBA 7(a) are built for acquisitions where intangible value is most of the price. The desk verifies the seller's collections, normalizes owner compensation and tests whether the practice carries the payment after the transition.
Do slow insurance payments hurt my file?
A payer lag is normal and expected. What matters is that collections are consistent and the accounts receivable aging is healthy. A line of credit sized to the lag is often the right structure, not a problem.
Can I finance imaging or dental equipment with installation included?
Yes. Soft costs such as installation, construction tied to the install and training are commonly included when documented on the quote and reasonable relative to the asset.
What credit score does a practice owner need?
The screening floor is 640. Individual programs can ask for more. Collections, payer mix and existing debt are weighed alongside credit, which is why a strong practice with a moderate score is still worth screening.
Will you work with associates buying into a practice?
Buy-ins are reviewed like acquisitions: the practice's collections, the buy-in agreement and the associate's production history. Start the file and describe the structure; the underwriter sorts the rest.
Bring the collections report, the aging and six statements.
That is enough to start. The underwriter sizes the structure to the payer cycle and tells you what, if anything, is missing.
Amounts, terms, timelines and pricing are typical ranges for complete files, are determined file by file, and are superseded by executed documents. Screening is a preliminary review, not a commitment to lend. Final terms depend on underwriting, collateral review, documentation, third-party reports and lender approval. SBA programs are additionally subject to SBA eligibility and approval. Qualified Commercial does not provide financial, accounting or legal advice.