Capital that arrives
before the remittance does.

A healthcare practice is one of the few businesses that delivers its product, documents it exhaustively, submits it for approval, and then waits months to find out what it will actually be paid. The gap between date of service and remittance runs 30 to 120 days depending on payer mix. Denials and rework stretch a fraction of it further. Meanwhile payroll runs every two weeks without exception, the lease is due on the first, supplies and lab bills arrive on their own schedule, and the malpractice premium does not care about your aging report. The practice can be busy, well-run, and genuinely profitable while still being short of cash on the fifteenth.

Banks handle this badly. They discount insurance receivables heavily or refuse to lend against them, because a claim is a contingent asset until adjudicated. They ask for two years of tax returns that show the owner's compensation structure rather than the practice's operating reality. They look at physician and dentist student loan balances and reprice accordingly. And they take 45 to 90 days, which is longer than most of the problems a practice needs solved. Legion underwrites the number that actually matters — what lands in the operating account — and moves at the speed the practice does.

What we fund inside a healthcare practice

Payroll bridges through a slow reimbursement cycle, a payer system migration, or a clearinghouse disruption. Equipment: dental chairs and operatories, CBCT and digital imaging, lasers, aesthetic platforms, ultrasound, in-house lab and point-of-care analyzers, sterilization, and the practice-management and EHR software that ties it together. Build-out and expansion — additional operatories or exam rooms, a second location, or a full relocation with the double-rent period that comes with it. Provider recruitment, including signing bonuses and the six-to-twelve-month ramp before a new associate's panel fills and their production covers their draw. Practice acquisition and partner buy-outs. Supply and inventory purchases, particularly for practices that buy implants, orthodontic appliances, or injectables in volume for pricing. Marketing for elective and cash-pay service lines where patient acquisition cost is a real and measurable investment.

What we don't ask for

We don't run hard credit pulls to check pricing. We don't ask for two years of tax returns. We don't require collateral on positions under $250K. We don't require you to switch clearinghouses, change your billing company, or route remittances through a lockbox we control. We don't touch protected health information — we underwrite from bank statements and summary collections data, never from patient records. We underwrite deposits, time in operation, and payer stability, which are the variables that actually predict repayment.

A generic underwriting engine misreads a healthy practice in predictable ways. The lumpy remittance pattern — large payer batches every two weeks rather than daily deposits — reads as inconsistency. The August dip in a pediatric or elective practice reads as decline. A single large equipment ACH reads as distress. Our underwriters know the difference. They look for the patterns that tell the real story: collections per month holding or trending up across trailing twelve months; a payer batch rhythm that repeats reliably; end-of-month balances that survive the payroll cycle; and NSF counts that stay in single digits despite heavy recurring ACH.

We also calibrate to your payer and service mix. A cash-pay or elective practice — aesthetics, cosmetic dentistry, concierge medicine, chiropractic, direct primary care — collects at the point of service and gets fast, flexible working capital sized to daily deposit rhythm. A commercial-heavy practice with predictable 30-to-45-day remittance gets a structure timed to that cycle. A Medicaid-heavy or home health practice with 60-to-120-day lag gets a longer term and AR-anchored sizing. Many practices run a blend, and we can structure so the cash-pay side carries the daily debit while the insurance side funds the larger investments.

Healthcare segments we fund every week

Primary care and internal medicine practices, single and multi-provider. Dental practices including general, orthodontic, periodontal, oral surgery, and multi-location DSO-adjacent groups. Specialty physician practices — dermatology, orthopedics, cardiology, gastroenterology, ophthalmology, and pain management. Behavioral health and substance-use treatment providers. Home health, hospice, and non-medical home care agencies. Physical, occupational, and speech therapy clinics. Urgent care and walk-in clinics. Diagnostic imaging and independent laboratories. Medical spas and aesthetic practices. Veterinary hospitals and specialty animal care. Durable medical equipment suppliers. Chiropractic and integrated wellness practices.

Common healthcare funding scenarios

A payer system migration stalls remittances for six weeks and two payroll runs land inside that window. We bridge the gap; the position repays as the backlog clears. A retiring dentist offers his book to an associate who has clinical skill and no capital. We fund the acquisition against the collections that already exist. A CBCT unit or aesthetic platform will pay for itself in eight months of new service-line revenue, but the vendor wants payment before install. We fund the equipment plus the build-out and training around it. A home health agency wins a referral relationship that doubles census, but Medicaid pays in 90 days and the caregivers get paid weekly. We fund the payroll gap through the ramp. A practice stacked three advances covering a slow quarter and now the daily debits are consuming the cushion that payroll depends on. We consolidate and cut the debit.

The pattern is consistent across all of it. In healthcare the work gets done long before the money arrives, and the practices that grow are the ones that do not have to wait on the remittance calendar to say yes.