WorkflowHealthcare Finance

Receivables Financing

Medical Receivables Financing

Medical receivables valued at what payers actually pay, payer by payer, with denials priced in.

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5specialist agents
5kinds of input
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The problem

Why it matters

Medical receivables are only worth what payers will pay; denials, contractual adjustments and aged claims hide in remittance files until collections fall short.

What it does

How the solution handles it

Agents read the aging, match remittances to claims, measure what each payer actually pays after contractual adjustments, track denial rates and days in AR, and apply eligibility and advance rates. A collateral manager approves the borrowing base.

How it works

How a borrowing base moves

Five agents read the aging, match remittances, analyse payer mix and denials, and compute eligibility; a collateral manager approves the base.

What comes in
Receivables in4 kinds of record · aging, remittances, contracts, denials
Agents at work
Aging readerby payer, by bucket
Then
Remittance matcher835 vs claims
Payer mix analystcontractual rates
Then
Denial trackerrate and reasons
Then
Eligibility calculatoradvance rates
A person decides
Collateral managerapproves the base
What comes out
Borrowing base
Payer view
Ineligibles
In and out

What it reads, and what it hands back.

What goes in

  • AR aging by payer
  • 835 remittance files and EOBs
  • Payer contracts and fee schedules
  • Denial and write-off reports
  • TPA and insurer settlements (India)

What comes out

  • Eligible receivables and borrowing base
  • Net collectible value by payer
  • Denial and days-in-AR trend
  • Ineligible list with reasons

Who uses it

CMCollateral managerHAHealthcare ABL analystCOCredit officerFEField examiner
What it changes

The difference, in numbers.

Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.

typical
11.8%
of claims initially denied in 2024; priced into every base
initial denial rate, 2024
target
30min
per monthly base, from aging and 835s to eligibility
By hand1–2 days
With agents≈ 30 min
estimated
3×
the healthcare borrowers each analyst can monitor
TodayWith agents

Source: Kodiak Solutions, 2024 initial denial rate 11.81% (May 2025) · “Typical” = published figure · “Target” = design goal, measured in the live solution · “Estimated” = our estimate

Built on the engine

5 specialist agents. One person decides.

Aging readeraging by payer and bucket
Remittance matcherwhat was paid against what was billed
Payer mix analystnet collectible by payer
Denial trackerdenial rate, reasons, trend
Eligibility calculatoreligible base, every exclusion cited
Collateral managerapproves the base

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