average time to get paid by the payer (Anahp 2025)
that the hospital finances between paying suppliers and getting paid
of revenue contested on the payer's first review
average EBITDA margin; nothing left to absorb the delay
Source: Anahp, Observatory Report 2026.
You delivered the care. The money comes in when the payer decides.
Between patient discharge and the credit in the bank there are three uncertainties the hospital doesn't control: when the payer will pay, how much it will deny and whether the appeal will be accepted. Meanwhile, payroll, OPME and suppliers come due on fixed dates.
The traditional route is the bank, which evaluates the hospital on past months' balance sheets and prices credit without seeing day-to-day production. Or financing through the payer itself: it advances money that already belongs to the hospital, charges for it and still decides how much to deny.
Timing. 77 days on average, with no fixed date.
Denials. 15.9% contested; the hospital works to recover what it has already produced.
Price. 2% to 3.5% a month with standard financing, and the denied amount still waits for the appeal.
Risk priced on what actually happens in the hospital.
They assess balance sheets, financial statements and collateral. A snapshot consolidated months later that doesn't see contracts, payers, payment times or denials.
They charge for uncertainty.
The denied amount is left out and waits for the appeal.
Runs the revenue cycle claim by claim, plan by plan. Knows which payer pays in 45 days and which pays in 120, which denials are appealed and which never come back.
Charges for real risk, already factoring in the receivable's improvement.
Initial denials come into cash without waiting for the appeal.
Whoever runs the claim sees the risk. Whoever sees the risk prices it better. Whoever prices it better can advance more of the production.
Unlike a pure fintech that only understands the hospital's balance sheet, we run and continuously optimize the revenue cycle, so the hospital depends less and less on credit.
Four steps. A flow you already know.
The hospital operates with Accrua's technology and revenue cycle team.
Integration with the HIS/ERP; claims audited, billed and tracked claim by claim.
Accrua reads production in real time.
By payer, plan and claim type: historical payment time, denial rate, accepted appeals. In 90 days, the risk reading is ready.
Eligible production comes into cash every month.
Facility structured through the Accrua FIDC, secured by payer receivables and without using bank credit lines. The only discount is the quarterly average final denial rate.
The payer pays Accrua, including what comes back on appeal.
The nearly 16% denied on first review, which the payer pays 90, 120 or even 300 days later after one or more appeals, was already in the hospital's bank account.
Eligible production is defined by contract per payer and claim type, with transparent criteria on the platform.
Technology, AI-powered people and capital. Under one contract.
Revenue cycle platform
Integrated with the HIS: claim auditing, billing, denial and appeal management, reconciliation.
AI-powered team
Accrua billing specialists and auditors running the cycle end to end, claim by claim, to prevent initial denials as much as possible.
Facility on eligible production
Structured credit on eligible production, minus only the quarterly average final denial rate.
Technology scales and prevents errors before they happen. Operations improve the engine. Capital solves the now. Together, the hospital stops depending on the payer's calendar and, in the medium term, on bank interest.
Three paths to the same cash.
Market financing range: public simulations from healthcare receivables financing platforms, 2026.
Credit is born from operations. That's why operations come first.
It's not a barrier. It's a benefit for clients who run the full revenue cycle with us, and the reason we can charge less and advance more, predictably.
Contract Accrua OS + Accrua Managed Operations.
A minimum of 90 days of joint operation for a granular reading of the receivable.
Structuring the facility on the eligible portfolio and the hospital's risk profile.
What CFOs ask first.
Is this a loan?
No. It's a facility structured on the hospital's eligible production, through the Accrua FIDC, secured by payer receivables.
What if the payer denies after the money has already come in?
Initial denials have already been advanced: the hospital doesn't wait the 90, 120 or even 300 days of appeals. All that's left out is the quarterly average final denial rate, the part the payer actually doesn't pay. The criteria are visible on the platform, by payer and claim type.
Why do I need to use Accrua's technology and operations first?
Because operations generate the claim-by-claim risk reading. Without it, we'd be reading balance sheets like everyone else, and charging like everyone else.
How much does it cost?
Pricing is set on the real risk of the hospital's portfolio, after the 90 days of joint operation. For reference, healthcare receivables financing in the market runs between 2% and 3.5% a month, without advancing the denied amount.
Will I lose control of billing?
No. The hospital is the controller of its data and decisions; Accrua operates with full transparency and an audit trail. Details are in the Trust Center.
Do I need to replace my management system?
No. The Accrua platform integrates with the HIS/ERP the hospital already uses.
How much of production comes into cash?
Eligible production, according to criteria defined in the contract by payer and claim type, minus the quarterly average final denial rate.
How soon does the money come in?
Monthly, 30 days after the hospital's production closes.
Does it work for nonprofit hospitals or hospitals serving SUS?
Eligibility applies to all hospitals that receive payments from private health plans.