Healthcare services operate on a payment timeline that no other industry accepts. You deliver care on Monday. You submit a claim on Wednesday. The payer processes the claim in 30-45 days. The explanation of benefits arrives. A portion is denied. You appeal. The appeal takes another 30 days. The approved amount is 60-70% of billed charges. The patient responsibility portion enters a separate collection cycle.
A home healthcare agency with 80 clinicians runs $400K in monthly payroll. Medicare reimburses in 30-45 days for clean claims, 60-90 days for claims requiring additional documentation. Medicaid timelines vary by state, ranging from 30 to 120 days. Commercial payers average 45-60 days. At any given time, $600K-$1M in delivered services sits in the reimbursement pipeline, moving through coding review, claim submission, payer processing, denial management, and appeals.
Non-emergency medical transport companies face a similar gap: trips are completed daily, but Medicaid reimbursement arrives in 60-120 days depending on the state and broker.